Alan J Moltz, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DO11476 Issued in AZ

Practice address

5855 W Utopia Rd
Glendale, AZ 85308-5251

Phone

(623) 537-6000

Fax

(623) 806-7010

NPI assigned

Oct 12, 2006

Last updated

Sep 23, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Previously, effective Sep 13, 2022 through Sep 13, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amoltz18618@direct.midwestern.edu

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.

• Midwestern University

  dba Midwestern University Dental Institute

  • Dental Clinic/Center
  • Glendale, AZ
  • NPI 1164744009
  NPD
• Midwestern University

  dba Midwestern University Eye Institute

  • Optometrist
  • Glendale, AZ
  • NPI 1891017745
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663891200000",
    "number": "1295824456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19389 N 59TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853086500",
            "telephone_number": "623-537-6000",
            "fax_number": "623-537-6014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5855 W UTOPIA RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853085251",
            "telephone_number": "623-537-6000",
            "fax_number": "623-806-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLTZ",
        "first_name": "ALAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019021411",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "DO11476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Alexander Molette, RPH, PHARM-D
• Elizabeth Molina
• Joann Marie Molina
• Molled Travel Vaccines, PLLC (Passport Health)
• Molly Moloznik, P.A.-C
• Andrea Marie Molus, OTR/L
• Momentum Counseling Services
• Sara Momika, RPH
• Monarch Dermatology and Wellness Center LLC
• Monarch Psychiatry LLC

• General Practice Dentistry in Glendale, AZ
• Providers in Glendale, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; 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.