Individual provider Active NPI

Ivo Moraguez, D.M.D.

  • Dentist
  • Royal Palm Beach, FL
National Provider Identifier
1053461954
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN12027 Issued in FL
Practice address
11358 Okeechobee Blvd
Suite 1
Royal Palm Beach, FL 33411-8723
Phone
(561) 790-0177
Fax
(561) 790-5291
NPI assigned
Jan 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN12027 FL Primary

Addresses

Primary practice location

11358 Okeechobee Blvd
Suite 1
Royal Palm Beach, FL 33411-8723

Mailing address

11358 Okeechobee Blvd
Suite 1
Royal Palm Beach, FL 33411-8723
Phone (561) 790-0177

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20150609002807 FL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4587985080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN12027FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Royal Palm Dental Associates, P.a. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053461954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11358 OKEECHOBEE BLVD",
            "address_2": "SUITE 1",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334118723",
            "telephone_number": "561-790-0177",
            "fax_number": "561-790-5291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11358 OKEECHOBEE BLVD",
            "address_2": "SUITE 1",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334118723",
            "telephone_number": "561-790-0177",
            "fax_number": "561-790-5291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAGUEZ",
        "first_name": "IVO",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN12027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.