Estephan J Moana Filho, DDS, MS, PHD

Primary specialty

DentistTaxonomy code 122300000X

License

FF64 Issued in MN

Practice address

515 Delaware St SE
6-440 Moos Tower
Minneapolis, MN 55455-0357

Phone

(612) 626-0140

Fax

(612) 626-0138

NPI assigned

Aug 14, 2014

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 MN

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

Specialty

Oral Surgery

Education

University of North Carolina School of Dentistry, 2013

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Doctor of Philosophy

Practice roles

Locations

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.

• Regents of the University of Minnesota

  • Federally Qualified Health Center (FQHC)
  • Minneapolis, MN
  • NPI 1114019858
  NPD
• Regents of the University of Minnesota

  • Oral and Maxillofacial Surgery Clinic/Center
  • Minneapolis, MN
  • NPI 1164763629
  NPD
• Regents of the University of Minnesota

  • Clinic Pharmacy
  • Minneapolis, MN
  • NPI 1528288875
  NPD

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

{
    "created_epoch": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407974400000",
    "number": "1306245329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 DELAWARE ST SE",
            "address_2": "6-320D MOOS TOWER",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550357",
            "telephone_number": "612-624-3130",
            "fax_number": "612-626-0138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 DELAWARE ST SE",
            "address_2": "6-440 MOOS TOWER",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550357",
            "telephone_number": "612-626-0140",
            "fax_number": "612-626-0138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOANA FILHO",
        "first_name": "ESTEPHAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS, MS, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-14",
        "last_updated": "2014-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "FF64",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mohamed Kadar Moalin
• Safia Moalin
• Sahra Abdirashid Moalin
• Laecretia Anisa Moallim
• Rokia Moallim
• Nader Moazami, MD
• Saied Mostafa Moazzami
• Holly Patrice Mobberley, LICSW
• Mobe, LLC
• Mobe, LLC

• Dentist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.