Individual provider Active NPI

Renee Alessi Moran, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Denver, CO
National Provider Identifier
1932483567
Registry record updated Jan 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
00010486 Issued in CO
Practice address
4380 S Syracuse St Ste 501
Denver, CO 80237-2628
Phone
(303) 694-4330
NPI assigned
Sep 30, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DEN 10486 CO
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 00010486 CO Primary

Addresses

Primary practice location

4380 S Syracuse St Ste 501
Denver, CO 80237-2628

Mailing address

4380 S Syracuse St Ste 501
Denver, CO 80237-2628

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20140618002191 FL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9335363068

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DEN 10486COMDDentist
00010486COMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1317340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546473600000",
    "number": "1932483567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4380 S SYRACUSE ST STE 501",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802372628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4380 S SYRACUSE ST STE 501",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802372628",
            "telephone_number": "303-694-4330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "RENEE",
        "middle_name": "ALESSI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-30",
        "last_updated": "2019-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "DEN 10486",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CO",
            "license": "00010486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.