Active NPI
Maisee Moua-McDaniel, DDS
- General Practice Dentistry
- Minneapolis, MN
National Provider Identifier
1831755776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D14178
- Practice address
- 1313 Penn Ave N
Minneapolis, MN 55411-3047 - Phone
- (612) 543-2500
- Fax
- (612) 302-4872
- NPI assigned
- May 16, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D14178 | MN | Primary |
Addresses
Primary practice location
1313 Penn Ave N
Minneapolis, MN 55411-3047
Mailing address
4497 Evergreen Dr
Vadnais Heights, MN 55127-3626
Phone (651) 894-4202
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D14178 | MN | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557964800000",
"number": "1831755776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4497 EVERGREEN DR",
"city": "VADNAIS HEIGHTS",
"state": "MN",
"postal_code": "551273626",
"telephone_number": "651-894-4202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1313 PENN AVE N",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554113047",
"telephone_number": "612-543-2500",
"fax_number": "612-302-4872"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOUA-MCDANIEL",
"first_name": "MAISEE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-16",
"last_updated": "2019-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MN",
"license": "D14178",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.