Individual provider Active NPI

Annmarie Moshos

  • General Practice Dentistry
  • Mooresville, NC
National Provider Identifier
1366734873
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10005 Issued in NC
Practice address
136A Rocky River Rd
Mooresville, NC 28115-7779
Phone
(704) 230-1470
NPI assigned
May 3, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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 10005 NC Primary

Addresses

Primary practice location

136A Rocky River Rd
Mooresville, NC 28115-7779

Mailing address

149 Ashford Hollow LN
Mooresville, NC 28117-9695
Phone (803) 517-3677

Other practice location 1

13605 Reese Blvd W
Huntersville, NC 28078
Phone (704) 948-1111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
10005NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lamarr W Holland DMD PLLC General Practice Current 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": "1304380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1366734873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 ASHFORD HOLLOW LN",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281179695",
            "telephone_number": "803-517-3677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136A ROCKY RIVER RD",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281157779",
            "telephone_number": "704-230-1470"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13605 Reese Blvd W",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "28078",
            "country_code": "US",
            "telephone_number": "704-948-1111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSHOS",
        "first_name": "ANNMARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-03",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "10005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; 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.