Tara Moustis, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Practice address

17037 Oak Park Ave
Tinley Park, IL 60477-2776

Phone

(708) 532-8322

Fax

(708) 532-9210

NPI assigned

Jan 6, 2007

Sex

Female

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

Enrolled in IL

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

Medicare enrollment (NPD)

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.

• Tara Moustis, D.D.S.,P.C.

  • General Practice Dentistry
  • Tinley Park, IL
  • NPI 1720136989
  NPD (past) Authorized official

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

{
    "created_epoch": "1168041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851449011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17037 OAK PARK AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772776",
            "telephone_number": "708-532-8322",
            "fax_number": "708-532-9210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17037 OAK PARK AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772776",
            "telephone_number": "708-532-8322",
            "fax_number": "708-532-9210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUSTIS",
        "first_name": "TARA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tashawna Mosley
• Mothercare Home Services LLC
• Nicole R Mott, DO
• Lindsey Motykowski, M.H.S. CCC-SLP
• Mount Carmel Services, Inc (Mount Carmer)
• MSM Healthcare Solutions, Inc (BrightStar Healthcare of Tinley Park)
• MSM Home Healthcare Solutions, Inc. (BrightStar Care of Tinley Park)
• Mucci World Management Inc,. (Mucci World)
• Brittany R Mueller, PTA
• Julie Mueller, LCPC

• General Practice Dentistry in Tinley Park, IL
• Providers in Tinley Park, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.