James William Moodt, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

15830 Issued in OH

Practice address

24700 Center Ridge Rd
One King James South, Suite #19
Westlake, OH 44145-5636

Phone

(440) 871-7979

Fax

(440) 871-7093

NPI assigned

Jul 31, 2006

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jun 22, 2015 through Jun 22, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424044800000",
    "number": "1427064567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24700 CENTER RIDGE RD",
            "address_2": "ONE KING JAMES SOUTH, SUITE #19",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455636",
            "telephone_number": "440-871-7979",
            "fax_number": "440-871-7093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24700 CENTER RIDGE RD",
            "address_2": "ONE KING JAMES SOUTH, SUITE #19",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455636",
            "telephone_number": "440-871-7979",
            "fax_number": "440-871-7093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODT",
        "first_name": "JAMES",
        "middle_name": "WILLIAM",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2015-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "15830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marcia C Mondie
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• William Hobbs Moore

• Dentist in Westlake, OH
• Providers in Westlake, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2015; 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.

Verify at the official NPI Registry.