Organization Active NPI

Morning Star Dental PA

  • General Practice Dentistry
  • Caldwell, ID
National Provider Identifier
1114069903
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D-3237 Issued in ID
Legal business name
MORNING STAR DENTAL PA
Practice address
4105 Clock Tower Ave
Caldwell, ID 83607-5006
Phone
(208) 455-9498
NPI assigned
Feb 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Darin R Mooso, DDS
Title
Dentist
Phone
(208) 455-9498

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X D-3237 ID Primary

Addresses

Primary practice location

4105 Clock Tower Ave
Caldwell, ID 83607-5006

Mailing address

9776 W State St
Star, ID 83669-5766
Phone (208) 455-9498

National Provider Directory

National Provider Directory

Locations

9776 W State St
Star, ID 83669
Phone (208) 898-4080

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114069903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9776 W STATE ST",
            "city": "STAR",
            "state": "ID",
            "postal_code": "836695766",
            "telephone_number": "208-455-9498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4105 CLOCK TOWER AVE",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836075006",
            "telephone_number": "208-455-9498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORNING STAR DENTAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOOSO",
        "authorized_official_first_name": "DARIN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "208-455-9498",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-3237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caldwell, ID

Sources for this page

  • 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.