Individual provider Active NPI

Norma Dale Niles-Moore, DDS

  • Dentist
  • Wichita, KS
National Provider Identifier
1437126646
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6069 Issued in KS
Practice address
2759 North Tyler Road
Wichita, KS 67205
Phone
(316) 721-4334
Fax
(316) 773-4592
NPI assigned
Mar 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6069 KS Primary

Addresses

Primary practice location

2759 North Tyler Road
Wichita, KS 67205

Mailing address

2759 North Tyler Road
Wichita, KS 67205
Phone (316) 721-4334

Other names 1

  • Norma Dale Niles-Moore Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160412002566 KS Order and Referring Only - DentistPractitioner - Dentist 4981902632

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6069KSMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Livewell Dental LLC PastSince Nov 7, 2025 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1437126646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2759 NORTH TYLER ROAD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67205",
            "telephone_number": "316-721-4334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2759 NORTH TYLER ROAD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67205",
            "telephone_number": "316-721-4334",
            "fax_number": "316-773-4592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NILES-MOORE",
        "first_name": "NORMA",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-07",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KS",
            "license": "6069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NORMA",
            "last_name": "NILES-MOORE",
            "middle_name": "DALE",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.