Robert John Mora, DDS

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

4009 Fort St
Lincoln Park, MI 48146-4110

Phone

(313) 928-8555

NPI assigned

May 1, 2024

Last updated

Jun 24, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Patrick J Kelly DDS , P.C

  dba Fort Street Dentistry

  • General Practice Dentistry
  • Lincoln Park, MI
  • NPI 1194081273
  NPD
• LGDC PLLC

  • Dental Clinic/Center
  • Grosse Pointe, MI
  • NPI 1548836935
  NPD (past)

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

{
    "created_epoch": "1714521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1417704156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 CASCADE AVE",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484303013",
            "telephone_number": "810-579-6408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4009 FORT ST",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481464110",
            "telephone_number": "313-928-8555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "660 Cadieux Rd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Grosse Pointe",
            "state": "MI",
            "postal_code": "482301552",
            "country_code": "US",
            "telephone_number": "313-885-5067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORA",
        "first_name": "ROBERT",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-01",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901602186",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Salahuddin Mohamed, PA
• Erin Monahan, LLBSW
• Joseph Anthony Montana, OD
• Melissa Montminy
• Moonstone Therapy LLC
• Erica Morris, LLMSW
• Angela Mosley
• James Moss, RPH
• Katherine Ann Motschall
• Assia Mouabbi, DDS

• Student in an Organized Health Care Education/Training Program in Lincoln Park, MI
• Providers in Lincoln Park, MI by specialty
• Student in an Organized Health Care Education/Training Program in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.