Patricia I Diaz-Moreno, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

10005 Issued in CT

Practice address

263 Farmington Ave # Mc2820
Farmington, CT 06030-2820

Phone

(860) 679-3170

Fax

(860) 679-8162

NPI assigned

Mar 2, 2010

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 CT

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

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

{
    "created_epoch": "1267488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420675200000",
    "number": "1851614002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE # MC2820",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060302820",
            "telephone_number": "860-679-3170",
            "fax_number": "860-679-8162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE # MC2820",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060302820",
            "telephone_number": "860-679-3170",
            "fax_number": "860-679-8162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ-MORENO",
        "first_name": "PATRICIA",
        "middle_name": "I",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-02",
        "last_updated": "2015-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CT",
            "license": "10005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Murali Dharan, M.D.
• Sonia Kaur Dhillon, M.D.
• Ashish Ramchandra Dhongade, M.D.
• Amy Di Mauro, LCSW
• Dialysis Clinic Inc.
• Anthony Diaz, MD
• Glorimar Rivera Diaz, FNP-BC
• Rubi R Diaz, APRN
• Alicia M Diclementi, OTR/L
• Kevin O Dieckhaus, MD

• Periodontics in Farmington, CT
• Providers in Farmington, CT by specialty
• Periodontics in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2015; 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.