Andrew R Moffitt, DDS MS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12062 Issued in MN

Practice address

502 Jefferson Hwy
Champlin, MN 55316

Phone

(763) 427-1311

Fax

(763) 427-1315

NPI assigned

Oct 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1851477020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 JEFFERSON HWY",
            "city": "CHAMPLIN",
            "state": "MN",
            "postal_code": "55316",
            "telephone_number": "763-427-1311",
            "fax_number": "763-427-1315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 JEFFERSON HWY",
            "city": "CHAMPLIN",
            "state": "MN",
            "postal_code": "55316",
            "telephone_number": "763-427-1311",
            "fax_number": "763-427-1315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOFFITT",
        "first_name": "ANDREW",
        "middle_name": "R",
        "credential": "DDS MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "12062",
            "primary": true
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "MN",
            "license": "12062",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer J Meister, OD
• Mighty Love Home Care Inc
• Minnesota Natural Medicine Center, PA
• Minneta Care LTD
• Modern Montessori Charter School
• Ahmed Mohamud
• Yasmine Moideen, PHD, LP
• Joan K Mokaya, RN
• Lawrence Thomas Mollo, MD
• Katelyn Moritz, CNP

• General Practice Dentistry in Champlin, MN
• Providers in Champlin, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.