Kevin Mosby

Primary specialty

DentistTaxonomy code 122300000X

License

35052 Issued in TX

Practice address

225 E Renfro St Ste 109
Burleson, TX 76028-3958

Phone

(817) 717-9086

NPI assigned

Nov 26, 2014

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

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1416960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735344000000",
    "number": "1760889299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 COTTON DEPOT LN APT 643",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761027801",
            "telephone_number": "281-658-9327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E RENFRO ST STE 109",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760283958",
            "telephone_number": "817-717-9086"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "506 Lenox Ave",
            "address_2": "Women's Pavilion 2nd Floor",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10037",
            "country_code": "US",
            "telephone_number": "212-939-2901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSBY",
        "first_name": "KEVIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-11-26",
        "last_updated": "2024-12-28",
        "certification_date": "2024-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "35052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Burleson, TX
• Providers in Burleson, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.