Individual provider Active NPI

Joan A Mosley-House, DDS

  • General Practice Dentistry
  • Philadelphia, PA
National Provider Identifier
1043349616
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS027135L Issued in PA
Practice address
7332 Brentwood Rd
Philadelphia, PA 19151-2215
Phone
(215) 473-5453
Fax
(215) 473-2363
NPI assigned
Mar 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS027135L PA Primary

Addresses

Primary practice location

7332 Brentwood Rd
Philadelphia, PA 19151-2215

Mailing address

309 Holly LN
Mankato, MN 56001-5422
Phone (507) 388-2120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231113002231 MN Practitioner - Dentist 8224318878 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Open Door Health Center CurrentSince Oct 31, 2023 Accepting new patients
Open Door Health Center General Practice CurrentSince Oct 31, 2023 Accepting new patients

Locations

309 Holly Ln
Mankato, MN 56001
Phone (507) 388-2120

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1043349616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 HOLLY LN",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560015422",
            "telephone_number": "507-388-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7332 BRENTWOOD RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191512215",
            "telephone_number": "215-473-5453",
            "fax_number": "215-473-2363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSLEY-HOUSE",
        "first_name": "JOAN",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS027135L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.