Individual provider Active NPI

Michael John Moran, D.D.S.

  • General Practice Dentistry
  • Metairie, LA
National Provider Identifier
1346342383
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3316 Issued in LA
Practice address
5037 Veterans Memorial Blvd
1B
Metairie, LA 70006-5136
Phone
(504) 456-2667
NPI assigned
Sep 1, 2006
Sex
Male
Sole proprietor
Yes

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
General Practice Dentistry 1223G0001X 3316 LA Primary

Addresses

Primary practice location

5037 Veterans Memorial Blvd
1B
Metairie, LA 70006-5136

Mailing address

5037 Veterans Memorial Blvd
1B
Metairie, LA 70006-5136
Phone (504) 456-2667

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20150804003360 LA Practitioner - Oral Surgery 2365756483 Practice locations: Metairie, LA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3316LAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346342383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5037 VETERANS MEMORIAL BLVD",
            "address_2": "1B",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700065136",
            "telephone_number": "504-456-2667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5037 VETERANS MEMORIAL BLVD",
            "address_2": "1B",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700065136",
            "telephone_number": "504-456-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "3316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.