Lucien Alanzo Moolenaar II, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

95 Issued in VI

Practice address

1403 4TH Street, Sugar Estate
Charlotte Amalie, VI 00802

Phone

(340) 228-8800

NPI assigned

Mar 5, 2014

Last updated

Mar 10, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1393977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394409600000",
    "number": "1629494372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 302275",
            "city": "CHARLOTTE AMALIE",
            "state": "VI",
            "postal_code": "008032275",
            "telephone_number": "340-228-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 4TH STREET, SUGAR ESTATE",
            "city": "CHARLOTTE AMALIE",
            "state": "VI",
            "postal_code": "00802",
            "telephone_number": "340-228-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOOLENAAR",
        "first_name": "LUCIEN",
        "middle_name": "ALANZO",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-05",
        "last_updated": "2014-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VI",
            "license": "95",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Charlotte Amalie, VI
• Providers in Charlotte Amalie, VI by specialty
• General Practice Dentistry in U.S. Virgin Islands

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2014; 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.