Organization Active NPI

Charles D Moorehead DDS LLC

  • Dentist
  • Blue Ash, OH
National Provider Identifier
1730964982
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
CHARLES D MOOREHEAD DDS LLC
Practice address
10427 Kenwood Rd
Blue Ash, OH 45242-3823
Phone
(513) 984-3817
Fax
(513) 984-3818
NPI assigned
Aug 28, 2023
Last updated
Aug 28, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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

Authorized official

Name
Phil Michael
Title
Coo
Phone
(513) 462-6583

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

10427 Kenwood Rd
Blue Ash, OH 45242-3823

Mailing address

10427 Kenwood Rd
Blue Ash, OH 45242-3823
Phone (513) 984-3817

National Provider Directory

National Provider Directory

Locations

10427 Kenwood Rd
Blue Ash, OH 45242
Phone (513) 984-3817

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1693180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693180800000",
    "number": "1730964982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10427 KENWOOD RD",
            "city": "BLUE ASH",
            "state": "OH",
            "postal_code": "452423823",
            "telephone_number": "513-984-3817",
            "fax_number": "513-984-3818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10427 KENWOOD RD",
            "city": "BLUE ASH",
            "state": "OH",
            "postal_code": "452423823",
            "telephone_number": "513-984-3817",
            "fax_number": "513-984-3818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES D MOOREHEAD DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-28",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A",
        "authorized_official_last_name": "MICHAEL",
        "authorized_official_first_name": "PHIL",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "513-462-6583"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Ash, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; 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.