Active NPI
William David Moncevicz, DMD
- General Practice Dentistry
- Wilmington, DE
National Provider Identifier
1174743199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2004211989
- Practice address
- 3521 Silverside Rd
Quillen Building Suite 2H
Wilmington, DE 19810-4900 - Phone
- (302) 477-9779
- Fax
- (302) 477-9119
- NPI assigned
- May 1, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2004211989 | DE | Primary |
Addresses
Primary practice location
3521 Silverside Rd
Quillen Building Suite 2H
Wilmington, DE 19810-4900
Mailing address
3521 Silverside Rd
Quillen Building Suite 2H
Wilmington, DE 19810-4900
Phone (302) 477-9779
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DE
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150721001695 | DE | Order and Referring Only - Dentist | 3274846134 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2004211989 | DE | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174743199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3521 SILVERSIDE RD",
"address_2": "QUILLEN BUILDING SUITE 2H",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198104900",
"telephone_number": "302-477-9779",
"fax_number": "302-477-9119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3521 SILVERSIDE RD",
"address_2": "QUILLEN BUILDING SUITE 2H",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198104900",
"telephone_number": "302-477-9779",
"fax_number": "302-477-9119"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONCEVICZ",
"first_name": "WILLIAM",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "DE",
"license": "2004211989",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wilmington, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.