Michael S Moody, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

S2-155C Issued in NV

Practice address

6200 N Durango Dr Ste 100
Las Vegas, NV 89149

Phone

(702) 660-5574

NPI assigned

Aug 8, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

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

Specialty

Oral Surgery

Education

Univ of Nevada, Las Vegas School of Dental Med, 2012

Medicare assignment

May accept Medicare assignment

Group practices

Falk Oral and Facial Surgery PLLCGroup PAC ID 9436516481, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Falk Oral & Facial Surgery, PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Las Vegas, NV
  • NPI 1922489350
  Medicare reassignment Care Compare group NPD
• North Valley Endodontics, P.a.

  • Endodontics
  • Phoenix, AZ
  • NPI 1659308641
  NPD (past)

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

{
    "created_epoch": "1344384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554768000000",
    "number": "1760739825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 N DURANGO DR STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891493916",
            "telephone_number": "801-915-4554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 N DURANGO DR STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89149",
            "telephone_number": "702-660-5574"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6200 N Durango Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "89149",
            "country_code": "US",
            "telephone_number": "702-660-5574",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3635 S Town Center Dr",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891353017",
            "country_code": "US",
            "telephone_number": "702-660-5576",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOODY",
        "first_name": "MICHAEL",
        "middle_name": "S",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-08",
        "last_updated": "2019-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AZ",
            "license": "9433",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "DRP1048",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NV",
            "license": "S2-155C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Casie Quinn Moody
• Chelsea Ann Moody, DO
• John Paul Moody III, D.C.
• Kimberly Moody
• Meisha Moody
• Shermeca Moody
• Sydney Moody
• Rachel Mooers
• Selena Moon-Smith
• Celina Moon

• Oral and Maxillofacial Surgery (Dentist) in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Oral and Maxillofacial Surgery (Dentist) in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.