Manmeet Kaur Bala Moody, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

55424 Issued in CA

Practice address

2755 W Bluff Ave
Fresno, CA 93611-0392

Phone

(559) 307-8287

NPI assigned

Jul 23, 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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 3, 2016 through Apr 3, 2028

Medicare enrollment (NPD)

Not enrolled

Interoperability endpoints

• Direct secure messaging: mbala@direct.westerndental.com

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465948800000",
    "number": "1942400353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2755 W BLUFF AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937110392",
            "telephone_number": "559-307-8287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2755 W BLUFF AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "936110392",
            "telephone_number": "559-307-8287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "MANMEET",
        "middle_name": "KAUR BALA",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-23",
        "last_updated": "2016-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "55424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa Montoya
• Roxana Margarita Montufar
• Victoria Montufar
• John David Moochy
• Bethany Angelica Moody
• Riley Moody
• Tonya Moody, LVN
• Christin Moon
• Joseph J Moon, D.M.D.
• Sohee Moon, DMD

• Dentist in Fresno, CA
• Providers in Fresno, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2016; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.