Moses Family Dentistry, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MOSES FAMILY DENTISTRY, LLC

Practice address

1776 N Airline Hwy Ste B
Gonzales, LA 70737-2127

Phone

(225) 369-0481

Fax

(225) 369-0482

NPI assigned

Jan 31, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Bradley Lee Moses, DDSNPI 1417448200

Title

Owner

Phone

(913) 602-0519

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bradley Lee Moses, DDS

  • General Practice Dentistry
  • Shreveport, LA
  • NPI 1417448200
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1675123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675123200000",
    "number": "1952007197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1535 RIVER PARKWAY BLVD APT 1002",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711041812",
            "telephone_number": "913-602-0519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1776 N AIRLINE HWY STE B",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707372127",
            "telephone_number": "225-369-0481",
            "fax_number": "225-369-0482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSES FAMILY DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-31",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A",
        "authorized_official_last_name": "MOSES",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "913-602-0519",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Moreau Physical Therapy Inc.
• Stacey G Moreau, M.ED., LPC
• Crystal Morgan
• Rachelle Stephens Morris, BCBA
• Gordon Ross Morrison
• Christian Moses
• Kayla Monique Moses, PHARM.D.
• Sindy Moses
• Robert Moukarzel, M.D.
• Moving Forward Counseling Center of Louisiana LLC

• Dental Clinic/Center in Gonzales, LA
• Providers in Gonzales, LA by specialty
• Dental Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.