KENNETH J MORAN (NPI# 1548200256) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548200256 |
| Entity Type | Individual |
| Full Name | KENNETH J MORAN |
| Credential | DDS |
| Practice Address |
167 North Main Street Tuba City AZ 86045-0600 |
| Mailing Address |
Po Box 600 167 North Main Street Tuba City AZ 86045-0600 |
| Practice Telephone | 9282832501 |
| Practice Fax Number | 9282832677 |
| Mailing Telephone | 9282832501 |
| Mailing Fax Number | 9282832677 |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2011-05-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
5577 | AZ | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 422329 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437373958 | Kenneth Moran | Anesthesiology | 410 W 10th Ave, N416 Doan Hall, Columbus, OH 43210-1240 | 2007-04-13 |
| Street Address |
167 NORTH MAIN STREET |
| City | TUBA CITY |
| State | AZ |
| Zip Code | 86045-0600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912906645 | Thomas Joseph Peters | Orthopaedic Surgery | 167 North Main Street, Tuba City, AZ 86045-0600 | 2005-07-15 |
| 1134696412 | Young Chou | Pharmacist | 167 North Main Street, Tuba City, AZ 86045 | 2018-10-25 |
| 1447736186 | Kenneth Hale | Dentist | 167 North Main Street, Tuba City, AZ 86045 | 2018-07-16 |
| 1659868024 | Bradley Hilken | Radiologic Technologist | 167 North Main Street, Tuba City, AZ 86045-0600 | 2018-04-20 |
| 1811484314 | Elizabeth Sullivan | Radiologic Technologist | 167 North Main Street, Tuba City, AZ 86045-0600 | 2018-04-19 |
| 1093217945 | Scott Cerreta | Respiratory Therapist, Registered | 167 North Main Street, Po Box 600, Tuba City, AZ 86045-0600 | 2018-03-07 |
| 1821502287 | Rachel Dye | Registered Nurse | 167 North Main Street, Tuba City, AZ 86045-0600 | 2017-11-21 |
| 1467965319 | Amber Vaughn | Registered Nurse | 167 North Main Street, Tuba City, AZ 86045-0600 | 2017-11-14 |
| 1639682701 | Roselita Sloan | Registered Nurse | 167 North Main Street, Tuba City, AZ 86045-0600 | 2017-11-13 |
| 1306359518 | Debra Marshall | Registered Nurse | 167 North Main Street, Tuba City, AZ 86045-0600 | 2017-11-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205434206 | Ambrielle Grace Begay | Specialist/Technologist | 48 Turquoise Drive, Tuba City, AZ 86045 | 2020-10-12 |
| 1063028124 | Fresenius Medical Care Tuba City, LLC | Clinic/Center | 50 S. Main Street, Ste 108, Tuba City, AZ 86045 | 2020-09-23 |
| 1609422484 | Rebekah Lee | Pharmacist | 167 North Main St. Tuba City Regional Health Care Corp., Tuba City, AZ 86045 | 2019-08-16 |
| 1861977050 | Kyle C Nguyen | Pharmacist | 3008 E. Birch Ave, Tuba City, AZ 86045 | 2018-10-03 |
| 1518419845 | John Glenn Ives | Pharmacist | 167 N, Main St, Tuba City, AZ 86045 | 2016-11-03 |
| 1497208433 | Toweringrock Non-emergency Medical Transport, LLC | Non-emergency Medical Transport (VAN) | 1029 E. Tc North Side Trailer, 36.153821-111.233925, Tuba City, AZ 86045 | 2016-07-26 |
| 1699153270 | Hopi Assisted Living Facility Inc. | Point of Service | 21 Senior Lane Upper Hud Housing Moenkopi, Hopi Assisted Living, Tuba City, AZ 86045 | 2015-05-14 |
| 1306223870 | Mia Seimy | Driver | Adair Avenue Space #5, Tuba City, AZ 86045 | 2015-05-04 |
| 1033507587 | Tari Carroll | Home Health Aide | Tumbleweed Drive Nha E-3, Tuba City, AZ 86045 | 2015-01-07 |
| 1023452984 | Amanda Bancroft Burrage | Pediatrics | 167 Main St., Tuba City, AZ 86045 | 2013-04-23 |
| Find all providers in zip 86045 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780800441 | Amy E Suhr | Dentist | 167 N. Main St., Tuba City Regional Health Care, Dental Department, Tuba City, AZ 86045 | 2007-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255945366 | Phoenix Wisdom Teeth, LLC | Dentist | 17037 N 43rd Ave # A4a, Glendale, AZ 85308-4026 | 2020-09-04 |
| 1962052035 | Summit Aesthetics LLC | Dentist | 34209 N. Scottsdale Rd, Suite 103, Scottsdale, AZ 85266 | 2019-09-19 |
| 1497317275 | Sandstone Oral Maxillofacial Surgery Pllc | Dentist | 20755 W Mcdowell Rd # 111, Buckeye, AZ 85396-2070 | 2019-07-02 |
| 1790254183 | Delsnyder Dental Corp | Dentist | 995 E Baseline Rd Apt 1172, Tempe, AZ 85283-1354 | 2018-11-15 |
| 1346717246 | Robison Orthodontics LLC | Dentist | 1355 S Higley Rd # 105, Gilbert, AZ 85296 | 2018-10-29 |
| 1932674108 | A. W. Ray Dds Md LLC | Dentist | 928 W Chandler Blvd Ste D-2, Chandler, AZ 85225-4900 | 2018-10-03 |
| 1457844516 | Chandler Oral and Maxillofacial Surgery | Dentist | 1799 E Queen Creek Rd Ste 4, Chandler, AZ 85286-2015 | 2018-06-12 |
| 1730681776 | Phoenix Oral and Maxillofacial Surgeons | Dentist | 9515 W Camelback Rd Ste 122, Phoenix, AZ 85037-1365 | 2018-03-06 |
| 1861993040 | Joseph E. Pierse, Dmd, Pllc | Dentist | 2060 W Whispering Wind Dr Ste 167, Phoenix, AZ 85085-2869 | 2018-02-23 |
| 1477075653 | Bertz Professional Corporation | Dentist | 3501 N Scottsdale Rd Ste 110, Scottsdale, AZ 85251-5649 | 2017-07-10 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.