DR. KENNETH EARL MOORE DDS NPI 1811035306

Dentist in Roseville, CA

NPI 1811035306 Individual Male Dentist PECOS Enrolled Opted-Out Medicare

About KENNETH MOORE

Kenneth Moore is a provider established in Roseville, California and his medical specialization is dentist. The NPI number of Kenneth Moore is 1811035306 and was assigned on February 2007. The practitioner's primary taxonomy code is 122300000X with license number CA30946 (CA). The provider is registered as an individual and his NPI record was last updated 14 years ago.

A dentist like Dr. Kenneth Earl Moore Dds is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.

Kenneth Moore is enrolled in PECOS and is eligible to order or refer healthcare services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).

Kenneth Moore is a non-participating provider of Medicare. If you are a Medicare beneficiary this means the provider can charge up to 15% more than Medicare's approved amount for the cost of rendered services, in addition to your normal deductible and coinsurance costs. There are some states that restrict the limiting charge when you see non-participating provider. If you pay the full cost of your care up front, your non- participating provider should still submit a claim to Medicare. Afterward, you should receive reimbursement from Medicare for up 80% of the Medicare-approved amount for the services rendered.

The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Kenneth Moore opted out of Medicare effective on 02-24-2014 until 02-24-2022. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.

NPI

1811035306

Provider NameDR. KENNETH EARL MOORE DDS
Provider Location Address729 SUNRISE AVE STE #400 ROSEVILLE, CA 95661
Provider Mailing Address729 SUNRISE AVE STE #400 ROSEVILLE, CA 95661
GenderMale
NPI Entity TypeIndividual
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date02-05-2007
Last Update Date07-08-2007


Primary Taxonomy

Taxonomy Code122300000X
ClassificationDentist
TypeDental Providers
License No.CA30946
License StateCA
Taxonomy DescriptionA 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.

Business Address

DR. KENNETH EARL MOORE DDS
729 SUNRISE AVE
STE #400
ROSEVILLE, CA
ZIP 95661
Phone: (916) 780-2022
Fax: (916) 784-7491

Get Directions


Mailing Address

DR. KENNETH EARL MOORE DDS
729 SUNRISE AVE
STE #400
ROSEVILLE, CA
ZIP 95661
Phone: (916) 780-2022
Fax: (916) 784-7491



Medicare Participation

Registered in PECOS? Yes What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
Opted-Out of MedicareYes
Opt-Out Effective Date02-24-2014
Opt-Out End Date02-24-2022
Eligible to Order and ReferYes
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesNo

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1871522664 LAMONT WALLACE HORNBECK M.D.
Individual
Dermatology729 SUNRISE AVE SUITE 700
ROSEVILLE, CA 95661
(916) 782-3721
1841217346DR. JAMES RAYMOND NOLEN
Individual
Chiropractor729 SUNRISE AVE SUITE 606
ROSEVILLE, CA 95661
(916) 786-0111
1164533444MS. JAN WILLIAMS BARTUSKA
Individual
Nurse Practitioner (Family)729 SUNRISE AVE SUITE 900
ROSEVILLE, CA 95661
(916) 781-3310
1184729279MS. JENNIFER L. TOTH NP
Individual
Nurse Practitioner (Women's Health)729 SUNRISE AVE SUITE 900
ROSEVILLE, CA 95661
(916) 781-3310
1003985508MRS. CATHERINE M. NIGRO RN
Individual
Registered Nurse729 SUNRISE AVE SUITE 900
ROSEVILLE, CA 95661
(916) 781-3387
1811061864DR. STEPHEN GARY MCCLURE PH.D.
Individual
Psychologist (Clinical)729 SUNRISE AVE SUITE 101
ROSEVILLE, CA 95661
(916) 782-3800
1184798035 COLLEEN MARIE STONE MFT
Individual
Marriage & Family Therapist729 SUNRISE AVE
ROSEVILLE, CA 95661
(916) 773-0437
1992863476 JOHN E ALLEN DDS
Individual
Dentist (General Practice)729 SUNRISE AVE SUITE 615
ROSEVILLE, CA 95661
(916) 783-4888
1174683346 JANET KAY THOMPSON FNP
Individual
Nurse Practitioner (Family)729 SUNRISE AVE SUITE 900
ROSEVILLE, CA 95661
(916) 781-3387
1538221056MRS. SUSAN CAROL BRYANT CMT
Individual
Massage Therapist729 SUNRISE AVE #606
ROSEVILLE, CA 95661
(916) 786-0111
1043355365 KATHRYN ODOM CALFEE M.A., MFT
Individual
Marriage & Family Therapist729 SUNRISE AVE SUITE 800
ROSEVILLE, CA 95661
(916) 772-6701
1881718237 HONG LUO MS, LAC
Individual
Acupuncturist729 SUNRISE AVE SUITE 602
ROSEVILLE, CA 95661
(916) 786-3222
1962616169DR. BILL E SPENCER JR. DC
Individual
Chiropractor729 SUNRISE AVE STE 606
ROSEVILLE, CA 95661
(916) 786-0111
1558569574A.O.S. PHYSICAL THERAPY
Organization
Physical Therapist729 SUNRISE AVE SUITE 602
ROSEVILLE, CA 95661
(530) 885-3940
1174700249DR. ALFRED OSOLIN DDS
Individual
Dentist729 SUNRISE AVE #102
ROSEVILLE, CA 95661
(916) 781-3737
1730350901VICTOR R SUCKESI DPM
Organization
Podiatrist (Foot & Ankle Surgery)729 SUNRISE AVE SUITE 607
ROSEVILLE, CA 95661
(916) 782-3900
1740457845A WOMAN'S PLACE, A MEDICAL CORPORATION, TATIANA FROMLAK, M.D., INC
Organization
Obstetrics & Gynecology729 SUNRISE AVE SUITE 800
ROSEVILLE, CA 95661
(916) 781-2971
1033353065ROSEVILLE PAIN MANAGEMENT, INC
Organization
Specialist729 SUNRISE AVE SUITE 612
ROSEVILLE, CA 95661
(916) 786-3222
1356676258MS. SHERRILL DOUGLASS-SMITH
Individual
Marriage & Family Therapist729 SUNRISE AVE SUITE 101
ROSEVILLE, CA 95661
(916) 955-3557
1487973293 MINTEVA JOHNISE LEE RN
Individual
Registered Nurse729 SUNRISE AVE STE 900
ROSEVILLE, CA 95661
(916) 771-6520

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.