Moses Rasberry, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.033786 Issued in IL

Practice address

6100 Washington Ave Ste F2
Mount Pleasant, WI 53406-4000

Phone

(262) 999-9998

NPI assigned

Jun 23, 2022

Last updated

Nov 27, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

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

{
    "created_epoch": "1655942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1841921442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18613 EMILY CT",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292448",
            "telephone_number": "773-562-1820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 WASHINGTON AVE STE F2",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534064000",
            "telephone_number": "262-999-9998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18613 Emily Ct",
            "address_purpose": "LOCATION",
            "city": "Hazel Crest",
            "state": "IL",
            "postal_code": "604292448",
            "country_code": "US",
            "telephone_number": "773-562-1820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RASBERRY",
        "first_name": "MOSES",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-23",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.033786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Mount Pleasant, WI
• Providers in Mount Pleasant, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.