Jack Frank Moores III, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

2901016423 Issued in MI

Practice address

42051 Mound Rd
Sterling Heights, MI 48314-3143

Phone

(586) 323-7700

Fax

(586) 323-7707

NPI assigned

Oct 17, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Maxillofacial Surgery

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oakland Oral Surgery AssociatesGroup PAC ID 9436196235, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jmoores1142041@direct.hfhs.org
• Direct secure messaging: jmooresi@direct.dmc.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Oakland Oral Surgery Associates

  • Oral and Maxillofacial Surgery (Dentist)
  • Sterling Heights, MI
  • NPI 1033299052
  Medicare reassignment Care Compare group NPD
• Oakland Oral Surgery Associates

  • Oral and Maxillofacial Surgery (Dentist)
  • Novi, MI
  • NPI 1437399870
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003996760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42051 MOUND RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483143143",
            "telephone_number": "586-323-7700",
            "fax_number": "586-323-7707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42051 MOUND RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483143143",
            "telephone_number": "586-323-7700",
            "fax_number": "586-323-7707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORES",
        "first_name": "JACK",
        "middle_name": "FRANK",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "2901016423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3111522",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aliya Maria Moody
• Erin Faith Mooney
• Frederick Henry Moore Jr.
• Glenn Moore, M.D.
• Tina Moore
• Andrea Morales
• Katelin Moran
• More Than Able Home Care LLC
• Hoda Morgan
• Mori Care at Home LLC

• Oral and Maxillofacial Surgery (Dentist) in Sterling Heights, MI
• Providers in Sterling Heights, MI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.