Individual provider Active NPI

Rebecca A Zakelj Moeller, DDS

  • Dentist
  • Cleveland, OH
National Provider Identifier
1487847406
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30.024136 Issued in OH
Practice address
1530 Saint Clair Ave NE
Cleveland, OH 44114-2004
Phone
(216) 781-6724
NPI assigned
Aug 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30.024136 OH Primary

Addresses

Primary practice location

1530 Saint Clair Ave NE
Cleveland, OH 44114-2004

Mailing address

2685 W 14TH St # 2
Cleveland, OH 44113-5215
Phone (617) 838-0676

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20171026000796 OH Order and Referring Only - DentistPractitioner - Dentist 7113293796

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1487847406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2685 W 14TH ST # 2",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441135215",
            "telephone_number": "617-838-0676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 SAINT CLAIR AVE NE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441142004",
            "telephone_number": "216-781-6724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAKELJ MOELLER",
        "first_name": "REBECCA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-22",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.024136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.