Individual provider Active NPI

Kevin Mosmen, DMD,MS

  • Dentist
  • Brick, NJ
National Provider Identifier
1477685683
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
02229600 Issued in NJ
Practice address
419 Nassau St
Brick, NJ 08723-5025
Phone
(732) 785-0002
Fax
(732) 785-2887
NPI assigned
Mar 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 02229600 NJ Primary

Addresses

Primary practice location

419 Nassau St
Brick, NJ 08723-5025

Mailing address

1610 Route 88 Ste 201
Brick, NJ 08724-3018
Phone (732) 785-0002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
02229600NJMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Kevin Mosmen Enterprises, LLC Dentist Current Accepting new patients
The Dental Difference LLC Dentist CurrentSince Jun 6, 2021 Accepting new patients

Locations

1610 Route 88
Ste 201
Brick, NJ 08724

419 Nassau St
Brick, NJ 08723
Phone (732) 477-1242

Organizations & group practices 2

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": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1477685683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 ROUTE 88 STE 201",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087243018",
            "telephone_number": "732-785-0002",
            "fax_number": "732-785-2887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 NASSAU ST",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087235025",
            "telephone_number": "732-785-0002",
            "fax_number": "732-785-2887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSMEN",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "DMD,MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "02229600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2021; 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.