Individual provider Active NPI

Jeff Molloy, DDS

  • Dentist
  • Oviedo, FL
National Provider Identifier
1821209990
Registry record updated May 18, 2016
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Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN21435 Issued in FL
Practice address
1013 Lockwood Blvd
Suite #7
Oviedo, FL 32765-6001
Phone
(407) 278-0934
NPI assigned
May 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN21435 FL Primary

Addresses

Primary practice location

1013 Lockwood Blvd
Suite #7
Oviedo, FL 32765-6001

Mailing address

1013 Lockwood Blvd
Suite #7
Oviedo, FL 32765-6001
Phone (407) 278-0934

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20160628002474 FL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7517258122

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463529600000",
    "number": "1821209990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 LOCKWOOD BLVD",
            "address_2": "SUITE #7",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327656001",
            "telephone_number": "407-278-0934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 LOCKWOOD BLVD",
            "address_2": "SUITE #7",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327656001",
            "telephone_number": "407-278-0934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLLOY",
        "first_name": "JEFF",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2016-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN21435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oviedo, FL

Sources for this page

Verify at the official NPI Registry.