Richard Bradley Moss, DDS, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

16526 Issued in TX

Practice address

1011 N Carroll Ave
Southlake, TX 76092-5305

Phone

(817) 488-6513

Fax

(817) 488-0487

NPI assigned

Oct 10, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Dr. Brad Moss Professional name

Medicare fee-for-service enrollment

Enrolled in TX

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

State licenses

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425427200000",
    "number": "1356439061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 N CARROLL AVE",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760925305",
            "telephone_number": "817-488-6513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 N CARROLL AVE",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760925305",
            "telephone_number": "817-488-6513",
            "fax_number": "817-488-0487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "RICHARD",
        "middle_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "DDS, PLLC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2015-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "16526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "D16526",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "731666",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRAD",
            "last_name": "MOSS",
            "prefix": "DR.",
            "credential": "DDS, PLLC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Lashanda Renee Morris
• Samantha Ysenia Morrison, NURSE PRACTITONER
• Steven M Morrison, M.D.
• Carla Larue Mosby, APRN, FNP
• Amy Moser, COTA
• Pooya Motaghedi
• Kael Moulton, D.C.
• John Mouser
• MTX Training System-Southlake, LLC
• Esther Mugwanya

• General Practice Dentistry in Southlake, TX
• Providers in Southlake, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2015; 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.