NPIMap

Individual provider Active NPI

Kirk Ira Moran, D.M.D., M.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Glendale, AZ
National Provider Identifier
1174893887
Registry record updated Jan 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
3062 Issued in AZ
Practice address
5750 W Thunderbird Rd
Suite H-800
Glendale, AZ 85306-4660
Phone
(602) 978-2100
Fax
(602) 978-0708
NPI assigned
Jan 11, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 3062 AZ Primary

Addresses

Primary practice location

5750 W Thunderbird Rd
Suite H-800
Glendale, AZ 85306-4660

Mailing address

5750 W Thunderbird Rd
Suite H-800
Glendale, AZ 85306-4660
Phone (602) 978-2100

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
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Orthodontists LTD Orthodontics and Dentofacial Orthopedics 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.

NPI Registry JSON

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

{
    "created_epoch": "1326240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326240000000",
    "number": "1174893887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5750 W THUNDERBIRD RD",
            "address_2": "SUITE H-800",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064660",
            "telephone_number": "602-978-2100",
            "fax_number": "602-978-0708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5750 W THUNDERBIRD RD",
            "address_2": "SUITE H-800",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064660",
            "telephone_number": "602-978-2100",
            "fax_number": "602-978-0708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "KIRK",
        "middle_name": "IRA",
        "credential": "D.M.D., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-11",
        "last_updated": "2012-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "AZ",
            "license": "3062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; 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.