Individual provider Active NPI

Joann Grace Moretti, DDS

  • Dentist
  • Oswego, IL
National Provider Identifier
1326110461
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Practice address
260 N Fernwood Rd
Oswego, IL 60543
Phone
(630) 859-8400
Fax
(630) 859-8683
NPI assigned
Nov 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X IL Primary

Addresses

Primary practice location

260 N Fernwood Rd
Oswego, IL 60543

Mailing address

260 N Fernwood Rd
Oswego, IL 60543
Phone (630) 859-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20160519000812 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7214239383

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
M and M Dental PC Dentist 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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326110461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 N FERNWOOD RD",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "60543",
            "telephone_number": "630-859-8400",
            "fax_number": "630-859-8683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 N FERNWOOD RD",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "60543",
            "telephone_number": "630-859-8400",
            "fax_number": "630-859-8683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORETTI",
        "first_name": "JOANN",
        "middle_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oswego, IL

Sources for this page

Verify at the official NPI Registry.