Jeffrey William Moos, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3139 Issued in WI

Practice address

680 Hehli Way
Mondovi, WI 54755-1639

Phone

(715) 926-5050

NPI assigned

Apr 6, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992827174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1471 VALLEY ESTATES RD",
            "city": "MONDOVI",
            "state": "WI",
            "postal_code": "547557899",
            "telephone_number": "715-926-5323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 HEHLI WAY",
            "city": "MONDOVI",
            "state": "WI",
            "postal_code": "547551639",
            "telephone_number": "715-926-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOOS",
        "first_name": "JEFFREY",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "3139",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "11386",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "8444",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "19026583",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Michael Miklesh, DDS
• Modern Dental Professionals, MN PC
• Mondovi Area Ambulance Commission
• Mondovi Physical Therapy,LLC
• Mondovi School District
• William R. Moos, D.D.S.
• Mountain Dental of New Mexico PC
• Nancy Polzer Hearing Aid Services
• Jenna Ruth Nehls, PHARMD
• Nancy Alice Olson-Bauer, P.T.

• General Practice Dentistry in Mondovi, WI
• Providers in Mondovi, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.