Active NPI
Stewart Edward Moreland, DMD
- Oral and Maxillofacial Pathology Dentistry
- Saint Louis, MO
National Provider Identifier
1417060138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Pathology Dentistry
- License
- 14036
- Practice address
- 2821 N Ballas Rd
Suite 225
St. Louis, MO 63131-2321 - Phone
- (314) 569-1012
- Fax
- (314) 569-1103
- NPI assigned
- Aug 16, 2006
- Last updated
- Apr 15, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Pathology Dentistry | 1223P0106X | 14036 | MO | Primary |
Addresses
Primary practice location
2821 N Ballas Rd
Suite 225
St. Louis, MO 63131-2321
Mailing address
2821 N Ballas Rd
Suite 225
St. Louis, MO 63131-2321
Phone (314) 569-1012
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 27, 2016 through Jan 27, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14036 | MO | MD | Oral and Maxillofacial Pathology Dentist |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Oral and Maxillofacial Surgery (Dentist)
- Saint Louis, MO
- NPI 1528503026
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208217600000",
"number": "1417060138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2821 N BALLAS RD",
"address_2": "SUITE 225",
"city": "ST. LOUIS",
"state": "MO",
"postal_code": "631312321",
"telephone_number": "314-569-1012",
"fax_number": "314-569-1103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2821 N BALLAS RD",
"address_2": "SUITE 225",
"city": "ST. LOUIS",
"state": "MO",
"postal_code": "631312321",
"telephone_number": "314-569-1012",
"fax_number": "314-569-1103"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORELAND",
"first_name": "STEWART",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-16",
"last_updated": "2008-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0106X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Pathology",
"state": "MO",
"license": "14036",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.