Leo Edward Moriarty, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7424 Issued in IA

Practice address

2441 21St St
Fort Campbell, KY 42223-5582

Phone

(270) 798-8751

Fax

(270) 956-0266

NPI assigned

Oct 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Moriarty Dental Group, PLC

  • General Practice Dentistry
  • Webster City, IA
  • NPI 1710060884
  NPD (past) Authorized official

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581033600000",
    "number": "1538242615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2441 21ST ST",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235582",
            "telephone_number": "270-798-8751",
            "fax_number": "270-956-0266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2441 21ST ST",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235582",
            "telephone_number": "270-798-8751",
            "fax_number": "270-956-0266"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "803 Ohio St",
            "address_purpose": "LOCATION",
            "city": "Webster City",
            "state": "IA",
            "postal_code": "505952850",
            "country_code": "US",
            "telephone_number": "515-832-3034",
            "fax_number": "515-832-5096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORIARTY",
        "first_name": "LEO",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "7424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1065797",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donald Arthur Moore, DDS
• Rufus William Moore Jr., M.D.
• Tamara Annette Moreland, PT
• Kathy L Morgan, LPN
• Sherry Lynn Morgan, LCSW
• Zachary Marshall Morin, PHARMD
• Parker Morris
• Trenton Chase Morris
• Cheryl Ann Morse, PA-C
• Tracey Jeannette Moss, LPN

• General Practice Dentistry in Fort Campbell, KY
• Providers in Fort Campbell, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2020; 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.