Individual provider Active NPI

David Russel Mosser, D.D.S.

  • Dentist
  • Noblesville, IN
National Provider Identifier
1306151683
Registry record updated May 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12011525A Issued in IN
Practice address
140 N 10TH St
Noblesville, IN 46060-2202
Phone
(317) 773-3888
NPI assigned
Aug 11, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12011525A IN Primary

Addresses

Primary practice location

140 N 10TH St
Noblesville, IN 46060-2202

Mailing address

140 N 10TH St
Noblesville, IN 46060-2202
Phone (317) 773-3888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20150528000250 IN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8921328287

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12011525AINMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
David R. Mosser, DDS, LLC 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": "1281484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431993600000",
    "number": "1306151683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 N 10TH ST",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460602202",
            "telephone_number": "317-773-3888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 N 10TH ST",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460602202",
            "telephone_number": "317-773-3888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSSER",
        "first_name": "DAVID",
        "middle_name": "RUSSEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-11",
        "last_updated": "2015-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12011525A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Noblesville, IN

Sources for this page

Verify at the official NPI Registry.