Organization Active NPI

Merit Dentistry of Indiana, PC

  • General Practice Dentistry
  • Evansville, IN
National Provider Identifier
1811311525
Registry record updated Feb 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MERIT DENTISTRY OF INDIANA, PC
Practice address
1015 Professional Blvd
Evansville, IN 47714-8010
Phone
(812) 437-1015
NPI assigned
Feb 17, 2014
Last updated
Feb 17, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2014

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

Authorized official

Name
Jeffrey Moos, DDS
Title
Ceo
Phone
(715) 318-2304

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

1015 Professional Blvd
Evansville, IN 47714-8010

Mailing address

1015 Professional Blvd
Evansville, IN 47714-8010
Phone (812) 437-1015

National Provider Directory

National Provider Directory

Locations

1015 Professional Blvd
Evansville, IN 47714
Phone (812) 437-1015

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": "1392595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392595200000",
    "number": "1811311525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 PROFESSIONAL BLVD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477148010",
            "telephone_number": "812-437-1015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 PROFESSIONAL BLVD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477148010",
            "telephone_number": "812-437-1015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIT DENTISTRY OF INDIANA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-17",
        "last_updated": "2014-02-17",
        "status": "A",
        "authorized_official_last_name": "MOOS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "715-318-2304",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2014; 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.