Eric David Moe, DMD

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

D14663 Issued in MN

Practice address

14065 Essex Ave
Apple Valley, MN 55124-6857

Phone

(952) 423-1909

NPI assigned

Sep 13, 2021

Last updated

Sep 13, 2021By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Cosmopolitan Orthodontics LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Lakeville, MN
  • NPI 1588899199
  NPD (past)
• Smile Doctors of Minnesota PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Albert Lea, MN
  • NPI 1255974325
  NPD (past)
• Smile Labs Services, LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Saint Paul, MN
  • NPI 1265948285
  NPD (past)

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

{
    "created_epoch": "1631491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631491200000",
    "number": "1336819267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 HENNEPIN AVE APT 108",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554011909",
            "telephone_number": "701-540-2833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14065 ESSEX AVE",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551246857",
            "telephone_number": "952-423-1909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3340 Sherman Ct",
            "address_purpose": "LOCATION",
            "city": "Eagan",
            "state": "MN",
            "postal_code": "551215012",
            "country_code": "US",
            "telephone_number": "651-406-8100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOE",
        "first_name": "ERIC",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-13",
        "last_updated": "2021-09-13",
        "certification_date": "2021-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MN",
            "license": "D14663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• MN Medical Respite and Recuperative
• Khalid Moalim
• Mobilecare Chiropractic, PLLC
• Modern Care Endodontics of Apple Valley
• Modern Dental Professionals MN PC (Midwest Dental)
• Abdimajid Ahmed Mohamed
• Abdirisak Mohamud Mohamed
• Naima Adam Mohamed
• Najah Ire Mohamed
• Rahma Sultan Mohamed

• Orthodontics and Dentofacial Orthopedics Dentistry in Apple Valley, MN
• Providers in Apple Valley, MN by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2021; 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.