Luis Moncada, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

21682 Issued in MA

Practice address

500 Raynham Street West
Raynham, MA 02767

Phone

(508) 822-6565

Fax

(508) 822-6525

NPI assigned

Jan 31, 2007

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

Medicare fee-for-service enrollment

Enrolled in LA

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

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629115688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3189",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132203189",
            "telephone_number": "315-454-6000",
            "fax_number": "315-454-8650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 RAYNHAM STREET WEST",
            "city": "RAYNHAM",
            "state": "MA",
            "postal_code": "02767",
            "telephone_number": "508-822-6565",
            "fax_number": "508-822-6525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONCADA",
        "first_name": "LUIS",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "21682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Menard, LICSW
• Wanda L Meyer, R.N.
• Terri Denise Miller, PMHNP-BC
• Shawn P Mills, M.D.
• Candace Mitchell
• Stacie Ann Morgado
• Leeann Morris
• Matthew Moura, DPT
• Naina Mulki, RPH
• Raymond Michael Murphy Jr., D.M.D.

• Dentist in Raynham, MA
• Providers in Raynham, MA by specialty
• Dentist in Massachusetts

• 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.
• 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.