Eddie Morales, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

7160-15 Issued in WI

Practice address

2933 W Layton Ave
Greenfield, WI 53221-2626

Phone

(414) 282-2642

NPI assigned

Jun 23, 2010

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Mar 30, 2016 through Mar 30, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Premier Periodontics LLC

  • Periodontics
  • Greenfield, WI
  • NPI 1770911976
  NPD (past)

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

{
    "created_epoch": "1277251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383609600000",
    "number": "1265743488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2933 W LAYTON AVE",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532212626",
            "telephone_number": "414-282-2642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2933 W LAYTON AVE",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532212626",
            "telephone_number": "414-282-2642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORALES",
        "first_name": "EDDIE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-23",
        "last_updated": "2013-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "WI",
            "license": "7160-15",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anoop Mohamed Iqbal, M.D
• Vicki Lynn Mohorich-Flanders, LCSW
• Nubia Esperanza Moieno Silva
• Joseph Molenda, B.S.
• Wendy L Moore, FNP-BC
• Dan Morawski IX
• Dermot J. More O'Ferrall, MD
• Christine Lorraine Morgan
• Tamara Morris, PSYD
• Amy M Moschell, MD

• Periodontics in Greenfield, WI
• Providers in Greenfield, WI by specialty
• Periodontics in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2013; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.