Lora B Moak, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4413 Issued in WV

Practice address

180 E 2ND Ave
Williamson, WV 25661-3602

Phone

(304) 236-5902

Fax

(304) 235-8559

NPI assigned

Jun 12, 2015

Last updated

Nov 30, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

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.

Enrollment records 1

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Williamson Health & Wellness Center Inc

  • Federally Qualified Health Center (FQHC)
  • Williamson, WV
  • NPI 1467711150
  Medicare reassignment NPD
• Williamson Health & Wellness Center Inc

  dba Williamson Health & Wellness Center-Mingo Central High School

  • Federally Qualified Health Center (FQHC)
  • Delbarton, WV
  • NPI 1225684731
  NPD
• Williamson Health & Wellness Center Inc

  dba Williamson Health & Wellness Center-Dental Clinic

  • Federally Qualified Health Center (FQHC)
  • Williamson, WV
  • NPI 1619536604
  NPD
• Williamson Health & Wellness Center Inc

  dba Williamson Health & Wellness Center -Licensed Behavioral Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Williamson, WV
  • NPI 1942840384
  NPD

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

{
    "created_epoch": "1434067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1548641814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2080",
            "city": "WILLIAMSON",
            "state": "WV",
            "postal_code": "256612080",
            "telephone_number": "606-794-4201",
            "fax_number": "304-235-8559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 E 2ND AVE",
            "city": "WILLIAMSON",
            "state": "WV",
            "postal_code": "256613602",
            "telephone_number": "304-236-5902",
            "fax_number": "304-235-8559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOAK",
        "first_name": "LORA",
        "middle_name": "B",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-12",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN21270",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "4413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mingo County Board of Education
• Mingo County Commission (Mingo County Emergency Services)
• Mingo County Family Wellness Center LLC
• Mingo Emergency Group PLLC
• Kimberly Mitchell
• Carolyn Mollett
• Keisha Nicole Montgomery, PRSS
• Megan Leigh Montgomery, APRN-CNP
• Della Jean Moore
• Joseph Darnell Moore

• General Practice Dentistry in Williamson, WV
• Providers in Williamson, WV by specialty
• General Practice Dentistry in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.