Kevin P Mooney, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

16749 Issued in MA

Practice address

10 Cedar St Ste 31
Woburn, MA 01801-6365

Phone

(781) 281-9111

Fax

(781) 281-9123

NPI assigned

Jan 10, 2007

Last updated

Nov 14, 2019By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2016 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Kevin P Mooney DDS PC

  • General Practice Dentistry
  • Woburn, MA
  • NPI 1578613865
  NPD (past) Authorized official
• Lukasiewicz and Bellavance LLC

  • General Practice Dentistry
  • Woburn, MA
  • NPI 1568985851
  NPD (past)

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573689600000",
    "number": "1750431177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CEDAR ST STE 31",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018016365",
            "telephone_number": "781-281-9111",
            "fax_number": "781-935-4804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CEDAR ST STE 31",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018016365",
            "telephone_number": "781-281-9111",
            "fax_number": "781-281-9123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOONEY",
        "first_name": "KEVIN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2019-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "16749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "X11819",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIAN",
            "identifier": "709783",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Colleen D Montemarano, PT,MS,DPT
• Kathleen Kennedy Montgomery, LICSW CAC
• Robert H Montgomery, LICSW CADAC
• Moon Hearing Services LLC
• Alysia S Moon, AU.D., CCC-A
• Danielle Rose Morais, RN
• Moramarco Chiropractic Office, P.C.
• Moramarco Chiropractic Offices, PC
• Marc Michael Moramarco, D.C.
• Christina Lauren Moreira

• General Practice Dentistry in Woburn, MA
• Providers in Woburn, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2019; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.