Moody Dental LLC

Primary specialty

DentistTaxonomy code 122300000X

License

12011396A Issued in IN

Legal business name

MOODY DENTAL LLC

Practice address

13955 Morse St
Cedar Lake, IN 46303-9639

Phone

(219) 374-5591

Fax

(219) 374-5592

NPI assigned

Dec 14, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Moody Wasif, D.M.D

Title

Dentist/Owner

Phone

(219) 322-6892

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hany Hany Reyad, DMD

  • Dentist
  • Demotte, IN
  • NPI 1104319177
  NPD (past)

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

{
    "created_epoch": "1450051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450051200000",
    "number": "1396110508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13955 MORSE ST",
            "city": "CEDAR LAKE",
            "state": "IN",
            "postal_code": "463039639",
            "telephone_number": "219-374-5591",
            "fax_number": "219-374-5592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13955 MORSE ST",
            "city": "CEDAR LAKE",
            "state": "IN",
            "postal_code": "463039639",
            "telephone_number": "219-374-5591",
            "fax_number": "219-374-5592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOODY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-14",
        "last_updated": "2015-12-14",
        "status": "A",
        "authorized_official_last_name": "WASIF",
        "authorized_official_first_name": "MOODY",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "219-322-6892",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IN",
            "license": "12011396A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terrence Scott McDermott, D.D.S.
• Emily McMillin, PT, DPT
• Gianna Mendez
• Midwest Express Care 4, LLC
• Jon D Misch, D.O.
• Alesha Moyer, FNP-C
• Mark Murzyn, PT
• Robin Nichols
• Traci L Noble, MSW, LCSW
• Kathryn Oetting

• Dentist in Cedar Lake, IN
• Providers in Cedar Lake, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2015; 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.