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DR. SERGIO MAURICIO MOELLER ZEVALLOS DDS MS NPI 1790970663


NPI Information

NPI: 1790970663
Provider Name: DR. SERGIO MAURICIO MOELLER ZEVALLOS, DDS, MS
Classification: Dentist - 1223P0700X
Entity Type: Individual

Specialization: Prosthodontics

PECOS Registration: Yes

Address:
2509 S STATE ST
ANN ARBOR, MI
ZIP 48104
Phone: (734) 662-7874
Get Directions

DR. Sergio Mauricio Moeller Zevallos, DDS, MS is a prosthodontics dentist in Ann Arbor, MI. The provider is that branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. DR. Sergio Mauricio Moeller Zevallos, DDS, MS NPI is 1790970663. 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:

2509 S STATE ST
ANN ARBOR, MI
ZIP 48104-145
Phone: (734) 662-7874
Fax: (734) 662-1518

The NPI 1790970663 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 9/13/2007 and was last updated on 12/1/2016.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1122300000XDentist2901018235MICHIGANNo
21223G0001XDentistGeneral Practice2901018235MICHIGANNo
31223P0700XDentistProsthodontics2901018235MICHIGANYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.