Seyed Moe Momen, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

3301 Issued in WV

Practice address

9 Chenoweth Drive
Bridgeport, WV 26330

Phone

(304) 842-1921

Fax

(604) 842-1960

NPI assigned

Nov 24, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pediatric and Adolescent Dentistry

  • Dental Clinic/Center
  • Bridgeport, WV
  • NPI 1669238572
  NPD

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306912258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 CHENOWETH DRIVE",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "26330",
            "telephone_number": "304-842-1921",
            "fax_number": "604-842-1960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 CHENOWETH DRIVE",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "26330",
            "telephone_number": "304-842-1921",
            "fax_number": "604-842-1960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOMEN",
        "first_name": "SEYED",
        "middle_name": "MOE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WV",
            "license": "3301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0138589000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karyn Lynette Molinari-Fryer, D.O.
• Sherilyn Molinaro
• Jennifer Jill Momen
• Joseph Momen, MD
• Sarah Momen, DDS
• Collin Moneypenny
• Saige Marie Mongold
• Lauryn Marie Moon, MS, OTR/L
• Allison Raeann Moore, DO
• April Moore

• Pediatric Dentistry in Bridgeport, WV
• Providers in Bridgeport, WV by specialty
• Pediatric Dentistry in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.