Jordan Michael Moffitt, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

9223 Issued in IA

Practice address

422 West Broadway
Eagle Grove, IA 50533-1704

Phone

(515) 448-4852

Fax

(515) 448-3533

NPI assigned

Jul 1, 2015

Last updated

Jul 1, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Moffitt Dental Center

  • Dental Clinic/Center
  • Eagle Grove, IA
  • NPI 1205093903
  NPD (past)

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

{
    "created_epoch": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435708800000",
    "number": "1982087524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 WEST BROADWAY",
            "city": "EAGLE GROVE",
            "state": "IA",
            "postal_code": "505331704",
            "telephone_number": "515-448-4852",
            "fax_number": "515-448-3533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 WEST BROADWAY",
            "city": "EAGLE GROVE",
            "state": "IA",
            "postal_code": "505331704",
            "telephone_number": "515-448-4852",
            "fax_number": "515-448-3533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOFFITT",
        "first_name": "JORDAN",
        "middle_name": "MICHAEL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-01",
        "last_updated": "2015-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "9223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271500633",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sydney Irish, OTR
• Rebecca Mae Jensen, OTD, OTR/L, ATC
• Sarah Lentz
• Mark P Magennis, PAC
• Moffitt Dental Center
• Michael W Moffitt, DDS
• Mother Ship LLC (Moffitt Dental)
• Parrott Family Chiropractic, P.C. (Eagle Grove Chiropractic)
• Aaron Michael Parrott, D.C.
• Rotary Club of Eagle Grove Home Inc

• Dentist in Eagle Grove, IA
• Providers in Eagle Grove, IA by specialty
• Dentist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2015; 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.