Individual provider Active NPI

William Bernard Moorkamp III, D.D.S.

  • Dentist
  • Rolla, MO
National Provider Identifier
1003099482
Registry record updated Dec 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
14121 Issued in MO
Practice address
912 N Cedar St
Rolla, MO 65401-3350
Phone
(573) 364-1345
Fax
(573) 364-4764
NPI assigned
Dec 9, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
14121MOMDDentist

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 14121 MO Primary

Addresses

NPPES NPI Registry

Primary practice location

912 N Cedar St
Rolla, MO 65401-3350

Mailing address

912 N Cedar St
Rolla, MO 65401-3350
Phone (573) 364-1345

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 9, 2007.

{
    "created_epoch": "1197158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197158400000",
    "number": "1003099482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 N CEDAR ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654013350",
            "telephone_number": "573-364-1345",
            "fax_number": "573-364-4764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 N CEDAR ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654013350",
            "telephone_number": "573-364-1345",
            "fax_number": "573-364-4764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORKAMP",
        "first_name": "WILLIAM",
        "middle_name": "BERNARD",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-09",
        "last_updated": "2007-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "14121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rolla, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.