Michael Shawn McMoran

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

14947 Issued in GA

Practice address

5830 Bond St
Suite 350
Cumming, GA 30040-0307

Phone

(404) 520-3223

NPI assigned

Aug 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2018 through Apr 1, 2028

Medicare enrollment (NPD)

Not 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.

• Dental Town, LLC

  • Dentist
  • Cumming, GA
  • NPI 1457657439
  NPD (past)

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459296000000",
    "number": "1538276597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5830 BOND ST",
            "address_2": "SUITE 350",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300400307",
            "telephone_number": "404-520-3223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5830 BOND ST",
            "address_2": "SUITE 350",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300400307",
            "telephone_number": "404-520-3223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMORAN",
        "first_name": "MICHAEL",
        "middle_name": "SHAWN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2016-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AR",
            "license": "3235",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "14947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154921608",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina McKellar, DMD
• Jacquelyn Denise McKinney, PSY.D.
• Kylie Christine McKnight
• Barbara Sharp McLear, FNP
• Kimberly McLeod
• Joseph P McNamara, D.C
• David Michael McQueeney, PH.D.
• Robin S McRee
• Cassandra Lynn McShane
• Alexandra McTier, D.M.D.

• Pediatric Dentistry in Cumming, GA
• Providers in Cumming, GA by specialty
• Pediatric Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.