Individual provider Active NPI

Andrew Joseph Moormann, D.D.S.

  • General Practice Dentistry
  • Burr Ridge, IL
National Provider Identifier
1215002340
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Practice address
50 Burr Ridge Pkwy Ste 101
Burr Ridge, IL 60527-0843
Phone
(630) 850-7799
NPI assigned
Nov 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X IL Primary

Addresses

Primary practice location

50 Burr Ridge Pkwy Ste 101
Burr Ridge, IL 60527-0843

Mailing address

50 Burr Ridge Pkwy Ste 101
Burr Ridge, IL 60527-0843
Phone (630) 850-7799

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150717000877 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5698088847

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019017731ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Morack Inc General Practice 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215002340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 BURR RIDGE PKWY STE 101",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605270843",
            "telephone_number": "630-850-7799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 BURR RIDGE PKWY STE 101",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605270843",
            "telephone_number": "630-850-7799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORMANN",
        "first_name": "ANDREW",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burr Ridge, IL

Sources for this page

Verify at the official NPI Registry.