Josiah Moutray, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2023025774 Issued in MO

Practice address

202 N Maple St
Eldon, MO 65026-1776

Phone

(573) 392-5213

NPI assigned

Jul 3, 2023

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

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Brandon K Bennett DDS LLC

  • Dental Clinic/Center
  • Eldon, MO
  • NPI 1801416722
  NPD

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

{
    "created_epoch": "1688342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1497432181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1917 BUNKER HILL RD",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651095606",
            "telephone_number": "816-383-4771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 N MAPLE ST",
            "city": "ELDON",
            "state": "MO",
            "postal_code": "650261776",
            "telephone_number": "573-392-5213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUTRAY",
        "first_name": "JOSIAH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-03",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2023025774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph M Meystrik, FNP
• Miller County Ambulance District
• MLH-DME, LLC
• MLH-RX, LLC
• MLH-RX, LLC
• Linda Mullins, L.M.T.
• Linda Sue Munkers
• N & R of Eldon, Inc.
• Sarah B Nelson
• Paul Laverne Oden, D.C.

• General Practice Dentistry in Eldon, MO
• Providers in Eldon, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; 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.