DR. MARK STEVEN MOELLER DDS NPI 1083895510

NPI Information

NPI: 1083895510
Provider Name: DR. MARK STEVEN MOELLER, DDS
Classification: Dentist - 1223P0221X
Entity Type: Individual

Specialization: Pediatric Dentistry

PECOS Registration: Yes

Address:
1836 SOUTH AVE
LA CROSSE, WI
ZIP 54601
Phone: (608) 782-7300
Get Directions

DR. Mark Steven Moeller, DDS is a pediatric dentistry dentist in La Crosse, WI. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. DR. Mark Steven Moeller, DDS NPI is 1083895510. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1836 SOUTH AVE
LA CROSSE, WI
ZIP 54601-429
Phone: (608) 782-7300

The NPI 1083895510 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 11/27/2007 and was last updated on 12/19/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	122300000X	Dentist		09067	IOWA	No
2	122300000X	Dentist		1001156	WISCONSIN	No
3	1223P0221X	Dentist	Pediatric Dentistry	S25	MINNESOTA	No
4	1223P0221X	Dentist	Pediatric Dentistry	1001156	WISCONSIN	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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