Andrew Feliciano Alfonso Moreno, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DDS104995 Issued in CA

Practice address

15531 Devonshire St
Mission Hills, CA 91345-2620

Phone

(818) 894-7979

NPI assigned

Mar 18, 2021

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

Not listed in the public Medicare enrollment file

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 and National Provider Directory roles.

• Jack O Moreno DDS Inc

  • General Practice Dentistry
  • Mission Hills, CA
  • NPI 1558472126
  NPD (past)

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

{
    "created_epoch": "1616025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1801472196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2206 PARKER CT",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930652439",
            "telephone_number": "805-390-7064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15531 DEVONSHIRE ST",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913452620",
            "telephone_number": "818-894-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "ANDREW FELICIANO",
        "middle_name": "ALFONSO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-18",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS104995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Moffett, MD
• Rahul K Mohan, M.D.
• Rafael D. Montalvo, M.D.
• Ana M Montoya
• Karla Moreira, COTA/L
• Jack O Moreno, DDS
• Motion Picture and Television Fund Medical Group Inc
• Grace Moussa, M.D.
• MP Care Corporation
• Brenda Munguia, LCSW

• Dentist in Mission Hills, CA
• Providers in Mission Hills, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; 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.