Jackson Moses, DDS, Inc

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

21174 Issued in CA

Legal business name

JACKSON MOSES, DDS, INC

Practice address

27800 Medical Center Rd
238
Mission Viejo, CA 92691-6410

Phone

(949) 364-0220

NPI assigned

Jan 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jackson Moses, DDSNPI 1427162932

Title

President

Phone

(949) 364-0220

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jackson Moses, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Mission Viejo, CA
  • NPI 1427162932
  NPD (past) Authorized official

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043377856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27800 MEDICAL CENTER ROAD",
            "address_2": "238",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27800 MEDICAL CENTER RD",
            "address_2": "238",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916410",
            "telephone_number": "949-364-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON MOSES, DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOSES",
        "authorized_official_first_name": "JACKSON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-364-0220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "21174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1427162932",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Sharon Jack, FNP
• Melissa Jackson
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• Anita Joy Jacob, MS
• Richard Jacob, M.D.

• Oral and Maxillofacial Surgery (Dentist) in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.