DR. KENNETH EARL MOORE DDS NPI 1811035306
Dentist in Roseville, CA
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 Name | DR. KENNETH EARL MOORE DDS |
| Provider Location Address | 729 SUNRISE AVE STE #400 ROSEVILLE, CA 95661 |
| Provider Mailing Address | 729 SUNRISE AVE STE #400 ROSEVILLE, CA 95661 |
| Gender | Male |
| NPI Entity Type | Individual |
| Is Sole Proprietor? | No |
| Is Organization Subpart? | N/A |
| Enumeration Date | 02-05-2007 |
| Last Update Date | 07-08-2007 |
Primary Taxonomy
| Taxonomy Code | 122300000X |
| Classification | Dentist |
| Type | Dental Providers |
| License No. | CA30946 |
| License State | CA |
| Taxonomy Description | 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. |
Business Address
DR. KENNETH EARL MOORE DDS
729 SUNRISE AVE
STE #400
ROSEVILLE, CA
ZIP 95661
Phone: (916) 780-2022
Fax: (916) 784-7491
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 Medicare | Yes |
| Opt-Out Effective Date | 02-24-2014 |
| Opt-Out End Date | 02-24-2022 |
| Eligible to Order and Refer | Yes |
| Eligible order / refer Part B Clinical Laboratory and Imaging | Yes |
| Eligible order / refer Durable Medical Equipment | Yes |
| Eligible order / refer Home Health Agency (HHA) | Yes |
| Eligible order / refer Power Mobility Devices | No |
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 | Dermatology | 729 SUNRISE AVE SUITE 700 ROSEVILLE, CA 95661 (916) 782-3721 |
| 1841217346 | DR. JAMES RAYMOND NOLEN Individual | Chiropractor | 729 SUNRISE AVE SUITE 606 ROSEVILLE, CA 95661 (916) 786-0111 |
| 1164533444 | MS. JAN WILLIAMS BARTUSKA Individual | Nurse Practitioner (Family) | 729 SUNRISE AVE SUITE 900 ROSEVILLE, CA 95661 (916) 781-3310 |
| 1184729279 | MS. JENNIFER L. TOTH NP Individual | Nurse Practitioner (Women's Health) | 729 SUNRISE AVE SUITE 900 ROSEVILLE, CA 95661 (916) 781-3310 |
| 1003985508 | MRS. CATHERINE M. NIGRO RN Individual | Registered Nurse | 729 SUNRISE AVE SUITE 900 ROSEVILLE, CA 95661 (916) 781-3387 |
| 1811061864 | DR. 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 Therapist | 729 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 |
| 1538221056 | MRS. SUSAN CAROL BRYANT CMT Individual | Massage Therapist | 729 SUNRISE AVE #606 ROSEVILLE, CA 95661 (916) 786-0111 |
| 1043355365 | KATHRYN ODOM CALFEE M.A., MFT Individual | Marriage & Family Therapist | 729 SUNRISE AVE SUITE 800 ROSEVILLE, CA 95661 (916) 772-6701 |
| 1881718237 | HONG LUO MS, LAC Individual | Acupuncturist | 729 SUNRISE AVE SUITE 602 ROSEVILLE, CA 95661 (916) 786-3222 |
| 1962616169 | DR. BILL E SPENCER JR. DC Individual | Chiropractor | 729 SUNRISE AVE STE 606 ROSEVILLE, CA 95661 (916) 786-0111 |
| 1558569574 | A.O.S. PHYSICAL THERAPY Organization | Physical Therapist | 729 SUNRISE AVE SUITE 602 ROSEVILLE, CA 95661 (530) 885-3940 |
| 1174700249 | DR. ALFRED OSOLIN DDS Individual | Dentist | 729 SUNRISE AVE #102 ROSEVILLE, CA 95661 (916) 781-3737 |
| 1730350901 | VICTOR R SUCKESI DPM Organization | Podiatrist (Foot & Ankle Surgery) | 729 SUNRISE AVE SUITE 607 ROSEVILLE, CA 95661 (916) 782-3900 |
| 1740457845 | A WOMAN'S PLACE, A MEDICAL CORPORATION, TATIANA FROMLAK, M.D., INC Organization | Obstetrics & Gynecology | 729 SUNRISE AVE SUITE 800 ROSEVILLE, CA 95661 (916) 781-2971 |
| 1033353065 | ROSEVILLE PAIN MANAGEMENT, INC Organization | Specialist | 729 SUNRISE AVE SUITE 612 ROSEVILLE, CA 95661 (916) 786-3222 |
| 1356676258 | MS. SHERRILL DOUGLASS-SMITH Individual | Marriage & Family Therapist | 729 SUNRISE AVE SUITE 101 ROSEVILLE, CA 95661 (916) 955-3557 |
| 1487973293 | MINTEVA JOHNISE LEE RN Individual | Registered Nurse | 729 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.