Jacob Brian Moss, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

14004167-9926 Issued in UT

Practice address

7632 S Campus View Dr Ste 150
West Jordan, UT 84084-5545

Phone

(801) 282-4142

NPI assigned

May 28, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Networks

• UT PPO D-SNP

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.

• West Jordan Modern Dentistry , LLP

  • General Practice Dentistry
  • West Jordan, UT
  • NPI 1508134412
  NPD (past)

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

{
    "created_epoch": "1716854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1255171245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2924 S GARDEN MEADOWS CV",
            "city": "SOUTH SALT LAKE",
            "state": "UT",
            "postal_code": "841061302",
            "telephone_number": "801-884-9386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7632 S CAMPUS VIEW DR STE 150",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840845545",
            "telephone_number": "801-282-4142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "JACOB",
        "middle_name": "BRIAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-28",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "14004167-9926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brynn Morrow
• Courtney Morse, NNP-BC
• Cydney Mortensen, PA
• Kaitlin Mortensen
• Elsa Morton
• Mount Zion Anesthesia LLC
• Mountain Peak Therapeutic Massage
• Mountain View Dental Care
• Mountain View Home Health and Hospice LLC
• Mountain West Behavioral Health

• General Practice Dentistry in West Jordan, UT
• Providers in West Jordan, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; 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.

Verify at the official NPI Registry.