Individual provider Active NPI

Taylor Zmoos, DDS

  • Pediatric Dentistry
  • Minot, ND
National Provider Identifier
1003358755
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
2313 Issued in ND
Practice address
2615 Elk Dr Ste 1
Minot, ND 58701
Phone
(701) 839-4440
Fax
(701) 839-1911
NPI assigned
Nov 12, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 2313 ND Primary
Dentist 122300000X 00202978 CO

Addresses

Primary practice location

2615 Elk Dr Ste 1
Minot, ND 58701

Mailing address

2615 Elk Dr Ste 1
Minot, ND 58701-1200
Phone (701) 839-4440

Other practice location 1

18335 E 103rd Ave Unit 103
Commerce City, CO 80022-3103
Phone (303) 536-3837

Other identifiers 1

IdentifierTypeStateIssuer
1451163MedicaidND

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
00202978COMDDentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1478908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1003358755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 ELK DR STE 1",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587011200",
            "telephone_number": "701-839-4440",
            "fax_number": "701-839-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 ELK DR STE 1",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "58701",
            "telephone_number": "701-839-4440",
            "fax_number": "701-839-1911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18335 E 103rd Ave Unit 103",
            "address_purpose": "LOCATION",
            "city": "Commerce City",
            "state": "CO",
            "postal_code": "800223103",
            "country_code": "US",
            "telephone_number": "303-536-3837",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZMOOS",
        "first_name": "TAYLOR",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-12",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "ND",
            "license": "2313",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "00202978",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1451163",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minot, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.