Mountain Dental of New Mexico PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DD3263 Issued in NM

Legal business name

MOUNTAIN DENTAL OF NEW MEXICO PC

Doing business as

Mountain Dental

Practice address

680 Hehli Way
Mondovi, WI 54755-1639

Phone

(715) 926-5050

Fax

(715) 926-5405

NPI assigned

Mar 21, 2011

Last updated

Mar 21, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey W Moos, DDSNPI 1992827174

Title

Owner

Phone

(715) 926-5050

Specialties & licenses 1

Addresses

Other names 1

• Mountain Dental Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeffrey William Moos, DDS

  • General Practice Dentistry
  • Mondovi, WI
  • NPI 1992827174
  Authorized official Same address or phone

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

{
    "created_epoch": "1300665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300665600000",
    "number": "1679872378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 HEHLI WAY",
            "city": "MONDOVI",
            "state": "WI",
            "postal_code": "547551639",
            "telephone_number": "715-926-5050",
            "fax_number": "715-926-5405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 HEHLI WAY",
            "city": "MONDOVI",
            "state": "WI",
            "postal_code": "547551639",
            "telephone_number": "715-926-5050",
            "fax_number": "715-926-5405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN DENTAL OF NEW MEXICO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-21",
        "last_updated": "2011-03-21",
        "status": "A",
        "authorized_official_last_name": "MOOS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-926-5050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD3263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mondovi Area Ambulance Commission (Mondovi Ambulance Service)
• Mondovi Physical Therapy,LLC
• Mondovi School District
• Jeffrey William Moos, DDS
• William R. Moos, D.D.S.
• Nancy Polzer Hearing Aid Services
• Jenna Ruth Nehls, PHARMD
• Nancy Alice Olson-Bauer, P.T.
• Sandra J Packard, NP
• Lisa Jane Palecek, IHP

• General Practice Dentistry in Mondovi, WI
• Providers in Mondovi, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2011; 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.