Individual provider Active NPI

Luis A. Moya, D.D.S

  • General Practice Dentistry
  • Palm Desert, CA
National Provider Identifier
1497846265
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
44036 Issued in CA
Practice address
72210 Highway 111
Ste. E-1
Palm Desert, CA 92260-2782
Phone
(760) 341-3009
Fax
(760) 341-3070
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 44036 CA Primary

Addresses

Primary practice location

72210 Highway 111
Ste. E-1
Palm Desert, CA 92260-2782

Mailing address

72210 Highway 111
Ste. E-1
Palm Desert, CA 92260-2782
Phone (760) 341-3009

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

State licenses

LicenseStateTypeSpecialty
44036CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497846265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72210 HIGHWAY 111",
            "address_2": "STE. E-1",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922602782",
            "telephone_number": "760-341-3009",
            "fax_number": "760-341-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72210 HIGHWAY 111",
            "address_2": "STE. E-1",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922602782",
            "telephone_number": "760-341-3009",
            "fax_number": "760-341-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYA",
        "first_name": "LUIS",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "44036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Desert, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.