John Joseph Moynihan, D.D.S., PA

Primary specialty

DentistTaxonomy code 122300000X

License

10537 Issued in MD

Practice address

10760 Rhode Island Ave
Beltsville, MD 20705-2513

Phone

(301) 937-4448

Fax

(301) 937-9108

NPI assigned

Jan 26, 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 1

Medicare fee-for-service enrollment

Enrolled in MD

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

Credentials

Physician Assistant

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219622400000",
    "number": "1366412652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10760 RHODE ISLAND AVE",
            "city": "BELTSVILLE",
            "state": "MD",
            "postal_code": "207052513",
            "telephone_number": "301-937-4448",
            "fax_number": "301-937-9108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10760 RHODE ISLAND AVE",
            "city": "BELTSVILLE",
            "state": "MD",
            "postal_code": "207052513",
            "telephone_number": "301-937-4448",
            "fax_number": "301-937-9108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYNIHAN",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.D.S., PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2008-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "10537",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "521983392",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Beltsville, MD
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• Dentist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2008; 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.