Nelson Antonio Morales, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D10733 Issued in OR

Practice address

30040 SW Boones Ferry Rd Ste 20
Wilsonville, OR 97070-8910

Phone

(503) 682-4500

NPI assigned

Sep 27, 2017

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

Enrolled in OR

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

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.

• Wilsonville Smiles PC

  • General Practice Dentistry
  • Wilsonville, OR
  • NPI 1346516192
  NPD (past)

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

{
    "created_epoch": "1506470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506470400000",
    "number": "1306355847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7578 ONEIL RD NE",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973031754",
            "telephone_number": "503-409-2324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30040 SW BOONES FERRY RD STE 20",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970708910",
            "telephone_number": "503-682-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORALES",
        "first_name": "NELSON",
        "middle_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-27",
        "last_updated": "2017-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D10733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D10733",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meredith Marie Mirsepassi, LPC, CADCI
• Modern Movement Medicine LLC
• Cheryl A Moffat, LMT
• Masha L Molodyh, OD
• Donald Rex Montgomery, PT,DPT
• Caitlin Moran
• Jessica Lynn Morey, PTA
• Betty Morgan
• Emily Morrow
• Amy Leeann Moulden

• General Practice Dentistry in Wilsonville, OR
• Providers in Wilsonville, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2017; 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.