MICHAEL S MOODY (NPI# 1760739825) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760739825 |
| Entity Type | Individual |
| Full Name | MICHAEL S MOODY |
| Credential | D.M.D. |
| Practice Address |
6200 N Durango Dr Ste 100 Las Vegas NV 89149 |
| Mailing Address |
6200 N Durango Dr Ste 100 Las Vegas NV 89149-3916 |
| Practice Telephone | 7026605574 |
| Mailing Telephone | 8019154554 |
| Enumeration Date | 2012-08-08 |
| Last Update Date | 2019-04-09 |
| 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 |
S2-155C | NV | Dental Providers |
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
9433 | AZ | Dental Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | DRP1048 | FL | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3635 S Town Center Dr, Las Vegas, NV 891353017 | 7026605576 | |
| 6200 N Durango Dr Ste 100, Las Vegas, NV 89149 | 7026605574 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952466583 | Michael Shannon Moody | Family Medicine | 8464 Adair Sreet, Douglasville, GA 30134-1877 | 2006-12-26 |
| 1033204094 | Michael Derrick Moody | Oral & Maxillofacial Surgery | 9990 W 26th Ave, Suite 100, Lakewood, CO 80215-1581 | 2006-10-04 |
| 1649652538 | Michael Moody | Pharmacist | 2301 Holmes St, Kansas City, MO 64108-2640 | 2015-06-26 |
| 1871890368 | Michael D Moody | Nurse Anesthetist, Certified Registered | 1444 Peterman Dr, Alexandria, LA 71301-3432 | 2011-02-17 |
| 1437180783 | Michael Anthony Moody | Pediatrics | 4101 N Roxboro St, Durham, NC 27704-2121 | 2006-07-05 |
| 1063489821 | Michael N Moody | General Practice | 507 N Main St, Salem, AR 72576-9449 | 2006-03-01 |
| Street Address |
6200 N DURANGO DR STE 100 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89149 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396284386 | Canyon Dental Implant Center LLC | Clinic/Center | 6200 N Durango Dr Ste 100, Las Vegas, NV 89149-3916 | 2017-02-23 |
| 1730629767 | Falk Oral & Facial Surgery, Pllc | Clinic/Center | 6200 N Durango Dr Ste 100, Las Vegas, NV 89149-3916 | 2017-02-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831796226 | Thompson Dental Pllc | Dentist | 9859 W. Deer Springs Way, Ste. 110, Las Vegas, NV 89149 | 2020-10-08 |
| 1699384941 | Dignity Select Nevada, LLC | Clinic/Center | 8675 W Rome Blvd, Las Vegas, NV 89149 | 2020-07-23 |
| 1225656945 | Vanlue Orthodontics, PC | Clinic/Center | 9855 W. Deer Springs Way, Suite 150, Las Vegas, NE 89149 | 2020-07-09 |
| 1285292052 | Dianne Pana | Physical Therapist | 351 N Fort Apache Rd, Las Vegas, NV 89149 | 2019-06-05 |
| 1477118198 | Cece Group Home, LLC | Community Based Residential Treatment Facility, Mental Illness | 5417 Ireland St, Las Vegas, NV 89149 | 2019-05-08 |
| 1790242543 | Carl Anthony Llanos Plaza | Nurse Practitioner | 6440 W Centennial Pkwy, Unit 155, Las Vegas, NV 89149 | 2019-02-28 |
| 1932664158 | Lychee Holdings, LLC | Skilled Nursing Facility | 8565 W Rome Blvd, Las Vegas, NV 89149 | 2019-02-01 |
| 1366976276 | Pam Squared At Las Vegas, LLC | Rehabilitation Hospital | 6166 North Durango Drive, Las Vegas, NV 89149 | 2017-04-18 |
| 1083076269 | Kristopher Kevin Kleinman | Registered Nurse | 5550 Painted Mirage Rd Ste 217, Las Vegas, NV 89149 | 2016-03-25 |
| 1326428962 | Kimberly Vialpando | Physical Therapist | 6351 N. Forte Apache Road, Las Vegas, NV 89149 | 2015-06-08 |
| Find all providers in zip 89149 | ||||
| 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 |
|---|---|---|---|---|
| 1568098309 | Moinca R Ponce | Dentist | 9450 West Russell Rd, Suite #103, Las Vegas, NV 89148 | 2020-03-12 |
| 1063061976 | Axiom Dentistry, LLC | Dentist | 8965 S Eastern Ave # 110, Las Vegas, NV 89123-4891 | 2019-09-04 |
| 1922657808 | Axiom Dentistry, LLC | Dentist | 410 S Rampart Blvd Ste 360, Las Vegas, NV 89145-5730 | 2019-09-04 |
| 1922533785 | Providence Dental Dhillon Pllc | Dentist | 10965 Lavender Hill Dr, # 6200, Las Vegas, NV 89135-2950 | 2017-04-28 |
| 1790136380 | Jordan Swarbrick | Dentist | 6180 N Decatur Blvd Ste 100, Las Vegas, NV 89130-1505 | 2016-06-25 |
| 1861848400 | Kevin Nowins | Dentist | 630 S Rancho Dr Ste B, Las Vegas, NV 89106-4849 | 2016-05-13 |
| 1922489350 | Falk Oral & Facial Surgery, Pllc | Dentist | 6200 North Durango Drive, Suite 100, Las Vegas, NV 89149-4408 | 2015-06-11 |
| 1467713859 | James J Schlesinger IIi | Dentist | 2040 W Charleston Blvd Ste 201, Las Vegas, NV 89102-2287 | 2012-06-02 |
| 1922365402 | Blair Alexander Isom | Dentist | 9368 Bronze River Ave, Las Vegas, NV 89149-1687 | 2012-04-20 |
| 1285924605 | Jesse Falk | Dentist | 6200 N Durango Dr, Suite 100, Las Vegas, NV 89138 | 2011-04-19 |
| Find all providers in LAS VEGAS | ||||
Please comment or provide details below to improve the information on MICHAEL S MOODY.
| 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.