Individual provider Active NPI

Nikia Moron, RDH

  • Dental Hygienist
  • Jbsa Ft Sam Houston, TX
National Provider Identifier
1164055471
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
16330 Issued in TX
Practice address
2940 Stanley Rd BLDG 2375
Jbsa Ft Sam Houston, TX 78234-2740
Phone
(210) 295-4095
NPI assigned
Feb 14, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 16330 TX Primary

Addresses

Primary practice location

2940 Stanley Rd BLDG 2375
Jbsa Ft Sam Houston, TX 78234-2740

Mailing address

2940 Stanley Rd BLDG 2375
Jbsa Ft Sam Houston, TX 78234-2740
Phone (210) 295-4095

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

Practice roles

OrganizationSpecialtyStatusNew patients
9590 Marbach San Antonio Services, PLLC PastSince Feb 1, 2020 Accepting new patients
Heritage Dental PastSince Feb 1, 2020 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1581638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1164055471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2940 STANLEY RD BLDG 2375",
            "city": "JBSA FT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782342740",
            "telephone_number": "210-295-4095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 STANLEY RD BLDG 2375",
            "city": "JBSA FT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782342740",
            "telephone_number": "210-295-4095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORON",
        "first_name": "NIKIA",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-14",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "TX",
            "license": "16330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jbsa Ft Sam Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; 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.