Active NPI
Elizabeth Moreau, DDS
- Dentist
- Mansfield, MA
National Provider Identifier
1154053627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN1859579
- Practice address
- 200 Chauncy St Ste 212
Mansfield, MA 02048-1200 - Phone
- (508) 942-3909
- NPI assigned
- Jun 24, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DDS-1386 | OK | |
| Student in an Organized Health Care Education/Training Program | 390200000X | MA | ||
| Dentist | 122300000X | DN1859579 | MA | Primary |
Addresses
Primary practice location
200 Chauncy St Ste 212
Mansfield, MA 02048-1200
Mailing address
6 Russet Hill Rd
Franklin, MA 02038-1373
Phone (508) 942-3909
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 |
|---|---|---|---|
| DN1859579 | MA | MD | Dentist |
| DDS-1386 | OK | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PLW Anesthesia LLC | 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.
-
- Certified Registered Nurse Anesthetist
- Oklahoma City, OK
- NPI 1700040680
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670889600000",
"number": "1154053627",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 RUSSET HILL RD",
"city": "FRANKLIN",
"state": "MA",
"postal_code": "020381373",
"telephone_number": "508-942-3909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 CHAUNCY ST STE 212",
"city": "MANSFIELD",
"state": "MA",
"postal_code": "020481200",
"telephone_number": "508-942-3909"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOREAU",
"first_name": "ELIZABETH",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-24",
"last_updated": "2022-12-13",
"certification_date": "2022-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OK",
"license": "DDS-1386",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MA",
"license": null,
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "DN1859579",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mansfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.