Jacob Moorhead, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D011356 Issued in AZ

Practice address

1130 S Country Club Dr Ste 101
Mesa, AZ 85210-4639

Phone

(480) 461-9866

NPI assigned

May 20, 2022

Last updated

May 17, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: westmesa@comfortdental.biz

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

{
    "created_epoch": "1653004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1922746858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 S COUNTRY CLUB DR STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852104639",
            "telephone_number": "480-461-9866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 S COUNTRY CLUB DR STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852104639",
            "telephone_number": "480-461-9866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORHEAD",
        "first_name": "JACOB",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-20",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D011356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "westmesa@comfortdental.biz",
            "affiliation": "N",
            "endpointDescription": "Office email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "1130 S Country Club Dr Ste 101",
            "city": "Mesa",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852104639",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michelle Marie Moore
• Nicole Marie Moore
• Seger Moore
• Vanessa Kaitlyn Moore, RBT
• Latosha Moorehead, RN
• Lorena Moorhead
• Nia Moquino
• Michael R Mora
• Armando Enrique Morales, PHARM D
• Baylee Morales, LPC

• General Practice Dentistry in Mesa, AZ
• Providers in Mesa, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.