E. Steven Moriconi, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DS021089L Issued in PA

Practice address

609 Harper Ave
Jenkintown, PA 19046-3206

Phone

(215) 884-8263

Fax

(215) 886-8975

NPI assigned

Jul 20, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 1, 2014 through Feb 1, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• E. Steven Moriconi, DMD, PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Jenkintown, PA
  • NPI 1508043217
  NPD (past) Authorized official
• Innovative Implant & Oral Surgery PC

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Feasterville Trevose, PA
  • NPI 1679547707
  NPD (past)

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193788800000",
    "number": "1043219108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 HARPER AVE",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190463206",
            "telephone_number": "215-884-8263",
            "fax_number": "215-886-8975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 HARPER AVE",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190463206",
            "telephone_number": "215-884-8263",
            "fax_number": "215-886-8975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORICONI",
        "first_name": "E.",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2007-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS021089L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RENDERING PROVID",
            "identifier": "427879F79",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "17815",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC/HIGHMARK BLUE SHIELD",
            "identifier": "427879",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Montgomery Allergy Associates LTD
• Montgomery Surgical Center
• Doryn Monvil
• Kiyoung Moon
• Christel Beth Morelli, CRNP
• Michael Peter Morton, M.F.T.
• Marylee Mundell, DO
• Adreeonah Alice Mundy
• Layne M Munson, MS, CCC-SLP
• Alexis Murray

• Oral and Maxillofacial Surgery (Dentist) in Jenkintown, PA
• Providers in Jenkintown, PA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.