Active NPI
Walter Lewis Moorhead III, D.D.S.
- Dentist
- Wrangell, AK
National Provider Identifier
1144409509
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 550
- Practice address
- 215 Front St
Wrangell, AK 99929-1140 - Phone
- (907) 874-3731
- Fax
- (907) 874-3531
- NPI assigned
- Nov 1, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 550 | AK | Primary |
Addresses
Primary practice location
215 Front St
Wrangell, AK 99929-1140
Mailing address
PO Box 1140
Wrangell, AK 99929-1140
Phone (907) 874-3731
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DD0550 | Medicaid | AK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 550 | AK | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DRS Moorhead& Ross DDS | 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 and National Provider Directory roles.
-
- General Practice Dentistry
- Wrangell, AK
- NPI 1659433738
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193875200000",
"number": "1144409509",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1140",
"city": "WRANGELL",
"state": "AK",
"postal_code": "999291140",
"telephone_number": "907-874-3731",
"fax_number": "907-874-3531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 FRONT ST",
"city": "WRANGELL",
"state": "AK",
"postal_code": "999291140",
"telephone_number": "907-874-3731",
"fax_number": "907-874-3531"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORHEAD",
"first_name": "WALTER",
"middle_name": "LEWIS",
"name_suffix": "III",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-11-01",
"last_updated": "2007-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AK",
"license": "550",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "DD0550",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wrangell, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.