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DR. NICHOLAS GEORGE MOOBERRY D.D.S.
NPI 1447371869
Dentist in Tigard, OR

Active since April 03, 2007PECOS Enrolled
7095 SW GONZAGA ST, TIGARD, OR 97223(855) 433-6825 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 21, 2022, Jul 29, 2020, Nov 4, 2019 and 2 more (5 updates tracked since 2017).

About Dr. Nicholas George Mooberry D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. NICHOLAS GEORGE MOOBERRY D.D.S. (NPI 1447371869) is an individual dentist in Tigard, Oregon, licensed in Oregon (D11147) and active in the NPI registry since April 2007. He is enrolled in Medicare PECOS and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1447371869
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. NICHOLAS GEORGE MOOBERRYCredential: D.D.S.
Location Address7095 SW GONZAGA STTigard, OR 97223-8309
Mailing Address6950 Ne Campus WayHillsboro, OR 97124-5611 · (855) 433-6825
Phone(855) 433-6825
Sole ProprietorNo
Enumeration DateApril 3, 2007
Last NPPES UpdateJuly 21, 20225 updates tracked since enumeration
NPPES CertifiedJuly 29, 2020
✔ NPI 1447371869 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in OR · D11147
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
Also ListedDentist · General PracticeTaxonomy 1223G0001X · License DO7002 (AZ), 7002 (AZ)
7095 SW GONZAGA ST, Tigard, OR 97223
Open in Google Maps ↗

Secondary Practice Locations 3

Location 11757 N Swan RdTucson, AZ 85712-3501 · Phone (520) 795-7733
Location 2151 W Speedway BlvdTucson, AZ 85705-7613 · Phone (520) 623-2733
Location 32460 Willamette StEugene, OR 97405 · Phone (541) 463-5206

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Nicholas George Mooberry D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97223 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$90.51 typical visit price
range $58.99 – $176.88
Typical copayment $22.62 (range $14.74 – $44.22)
Most-billed visit code 99203
Established Patient
$73.28 typical visit price
range $19.32 – $144.79
Typical copayment $18.32 (range $4.83 – $36.19)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DEAN ROY GRETZINGER DDS
Dentist
7095 SW GONZAGA ST
TIGARD, OR 97223
Washington County (855) 433-6825
DR. HUJATULLAH BAYAT DDS
Dentist (Endodontics)
7095 SW GONZAGA ST
TIGARD, OR 97223
Washington County (925) 642-0917
DR. CHRISTIAN B KECHT DDS
Dentist (Endodontics)
7095 SW GONZAGA ST
TIGARD, OR 97223
Washington County (150) 362-0809
MISHAUN SAHEBI
Dentist (Oral and Maxillofacial Surgery)
7095 SW GONZAGA ST
TIGARD, OR 97223
Washington County (855) 433-6825
DR. CRYSTAL DEWI ROSLINA KRISWANDI DMD
Dentist (General Practice)
7095 SW GONZAGA ST
TIGARD, OR 97223
Washington County (855) 433-6825
DR. BHARATHI DEVI MYNENI BDS
Dentist (Periodontics)
7095 SW GONZAGA ST
TIGARD, OR 97223
Washington County (855) 433-6825
SUZAN NGUYEN DMD
Dentist
7095 SW GONZAGA ST
TIGARD, OR 97223
Washington County (503) 952-2137
DR. LINDSAY K TAIRA DMD
Dentist
7095 SW GONZAGA ST
TIGARD, OR 97223
Washington County (855) 433-6825

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicholas Mooberry's NPI number?

The NPI number for Nicholas Mooberry is 1447371869. It was assigned to this individual provider in the NPPES registry on April 3, 2007.

Where is Nicholas Mooberry located?

Nicholas Mooberry practices at 7095 SW Gonzaga St, Tigard, OR 97223. The listed phone number is (855) 433-6825.

What is Nicholas Mooberry's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Nicholas Mooberry enrolled in Medicare?

Yes. Nicholas Mooberry is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Nicholas Mooberry was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.