Shaneka Marks Moss DDS PC

Primary specialty

DentistTaxonomy code 122300000X

License

25693 Issued in TX

Legal business name

SHANEKA MARKS MOSS DDS PC

Practice address

5103 Magna Carta Blvd
Suite 100
Grand Prairie, TX 75052-5213

Phone

(972) 352-6677

Fax

(972) 352-6678

NPI assigned

Sep 23, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Shaneka Marks Moss, DDSNPI 1962716399

Title

Owner

Phone

(972) 352-6677

Specialties & licenses 1

Addresses

Other names 1

• Lavender Dental Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shaneka S Marks Moss, D.D.S

  • Dentist
  • Grand Prairie, TX
  • NPI 1962716399
  NPD (past) Authorized official

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

{
    "created_epoch": "1379894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379894400000",
    "number": "1487080404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5103 MAGNA CARTA BLVD",
            "address_2": "SUITE 100",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750525213",
            "telephone_number": "972-352-6677",
            "fax_number": "972-352-6678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5103 MAGNA CARTA BLVD",
            "address_2": "SUITE 100",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750525213",
            "telephone_number": "972-352-6677",
            "fax_number": "972-352-6678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANEKA MARKS MOSS DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-23",
        "last_updated": "2013-09-23",
        "status": "A",
        "authorized_official_last_name": "MARKS MOSS",
        "authorized_official_first_name": "SHANEKA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-352-6677",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "25693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lavender Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Debra E. Seznik, D.D.S.
• Riya Sanjay Shah
• Isheta Shahed, M.D.
• Karim Shallwani, D.D.S.
• Shalom Coker 24 Hours Special Needs Daycare
• Raushanah Taherrah Shareef-Jefferson, RDH, IBCLC
• Kathleen Elizabeth Sharp, MD
• Wendy Michele Sharp, MS CCC/SLP
• Shebah Care LLC
• Naureen Sheikh, M.D.

• Dentist in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2013; 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.