Individual provider Active NPI

Michael Ryan Moraguez, DMD

  • General Practice Dentistry
  • Royal Palm Beach, FL
National Provider Identifier
1528554516
Registry record updated Jul 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN23404 Issued in FL
Practice address
11358 Okeechobee Blvd Ste 1
Royal Palm Beach, FL 33411
Phone
(561) 790-0177
NPI assigned
Jul 2, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2019

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 DN23404 FL Primary

Addresses

Primary practice location

11358 Okeechobee Blvd Ste 1
Royal Palm Beach, FL 33411

Mailing address

11358 Okeechobee Blvd Ste 1
Royal Palm Beach, FL 33411-8723

Other practice location 1

9200 113th St
Seminole, FL 33772-2800
Phone (727) 394-6064

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
DN23404FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Royal Palm Dental Associates, P.a. General Practice Past Accepting new patients

Organizations & group practices 1

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": "1530489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562630400000",
    "number": "1528554516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11358 OKEECHOBEE BLVD STE 1",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334118723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11358 OKEECHOBEE BLVD STE 1",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "33411",
            "telephone_number": "561-790-0177"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9200 113th St",
            "address_purpose": "LOCATION",
            "city": "Seminole",
            "state": "FL",
            "postal_code": "337722800",
            "country_code": "US",
            "telephone_number": "727-394-6064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORAGUEZ",
        "first_name": "MICHAEL",
        "middle_name": "RYAN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-02",
        "last_updated": "2019-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN23404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; 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.