Daniel T Moran, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Practice address

4105 Frontage Rd
Peru, IL 61354-1115

Phone

(815) 223-5839

Fax

(815) 223-0957

NPI assigned

Apr 16, 2007

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

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 and National Provider Directory roles.

• Alpha Dental Care

  • Dentist
  • Peru, IL
  • NPI 1386981371
  NPD (past)

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386869287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 W CAROL AVE",
            "city": "CORTLAND",
            "state": "IL",
            "postal_code": "601124107",
            "telephone_number": "815-787-8408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4105 FRONTAGE RD",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613541115",
            "telephone_number": "815-223-5839",
            "fax_number": "815-223-0957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "DANIEL",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy John Mertes, D.C.
• Patricia Michaels
• Heather Lynn Miller, CNM
• Roger T Miller, DC
• Robert J Mitchell, D.O.
• Donna Kay Morscheiser, RPH
• Muscle Pain Clinic Inc
• Julee Nawa
• Barbara Jean Needs, D.C.
• Anne M Neumann, O.D.

• All providers in Peru, IL
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.