DR. KEITH EDWIN MOOMAW (NPI# 1164645859) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164645859 |
| Entity Type | Individual |
| Full Name | DR. KEITH EDWIN MOOMAW |
| Credential | DDS |
| Practice Address |
1308 Business Center Way Suite 105 Edgewood MD 21040-1504 |
| Practice Telephone | 4106792790 |
| Mailing Telephone | 4106792790 |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | MD6960 | MD | Dental Providers |
| Street Address |
1308 BUSINESS CENTER WAY SUITE 105 |
| City | EDGEWOOD |
| State | MD |
| Zip Code | 21040-1504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942328364 | Peter Hamilton Roth | Dentist | 1308 Business Center Way, Suite 105, Edgewood, MD 21040-1504 | 2007-03-26 |
| 1649597824 | Chesapeake Contemporary Dentistry, P.a. | Dentist | 1308 Business Center Way, Suite 105, Edgewood, MD 21040-1504 | 2010-04-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275028458 | Alycia Covelly | Counselor | 2415 Willoughby Beach Rd, Edgewood, MD 21040 | 2018-06-29 |
| 1558885491 | Kenneth J Heil Jr. | Physical Therapist | 1401f Pulaski Highway, Edgewood, MD 21040 | 2017-08-02 |
| 1952845810 | Caroline Njane | Registered Nurse | 835 Clover Leaf Ct, Edgewood, MD 21040 | 2016-12-12 |
| 1003368945 | Rts Edgewood | Clinic/Center | 2205 Pulaski Hwy, Edgewood, MD 21040 | 2016-10-26 |
| 1194133033 | Dante Winter | Pharmacist | 1301 Woodbridge Center Way, Edgewood, MD 21040 | 2014-07-23 |
| 1841469723 | Rafiq Patel M D P A | General Practice | 1952 Pulaski Highway, Edgewood, MD 21040 | 2008-02-26 |
| 1871793877 | Nichols Shelter Home for Elderly | Health Maintenance Organization | 1111 Hanson Rd., Edgewood, MD 21040 | 2007-07-19 |
| 1467505362 | William N Bernhard | Preventive Medicine | 2624 Fairview Pt Rd. Bldg E 6814, Aviation Medicine Clinic, Edgewood (apg), MD 21040 | 2007-01-22 |
| 1417006503 | Phoenix Recovery Center Inc | Clinic/Center | 107 Edgewood Rd, Edgewood, MD 21040 | 2007-01-09 |
| 1093886848 | Fernando Jose Narava | Dentist | 9690 Deereco, Suite 120, Timonium, MD 21040 | 2006-11-13 |
| Find all providers in zip 21040 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| 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. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881999761 | Dennis W. Jackson | Dentist | 164 Square H Rd, Edgewood, NM 87015-9538 | 2011-01-24 |
| 1417076522 | Peter Y Chien | Dentist | 2222 Meridian Ave E Ste C, Edgewood, WA 98371-1032 | 2007-03-28 |
| 1346311321 | Thomas F Goeke | Dentist | 610 Medical Village Dr, Edgewood, KY 41017-3416 | 2006-11-13 |
| 1366549024 | Robert Lee Pollard | Dentist | 2101 Meridian Ave E, Edgewood, WA 98371-1008 | 2006-09-17 |
| 1194383752 | Craig Testerman | Dentist | 7 Municipal Way, Edgewood, NM 87015-7086 | 2019-05-30 |
| 1154614295 | Jason A Ford | Dentist | 155 Barnwood Dr, Edgewood, KY 41017-2585 | 2011-05-23 |
| 1346556040 | Shamaine Spencer | Dentist | 8 Medical Center Rd, Edgewood, NM 87015-7086 | 2010-08-19 |
| 1649597824 | Chesapeake Contemporary Dentistry, P.a. | Dentist | 1308 Business Center Way, Suite 105, Edgewood, MD 21040-1504 | 2010-04-27 |
| 1881723559 | Patrick M Nutini Psc | Dentist | 3005 Dixie Hwy, Suite 250, Edgewood, KY 41017 | 2007-03-05 |
| 1134103211 | Louis R Bush | Dentist | 8 Medical Center Rd, Edgewood, NM 87015-7086 | 2005-12-02 |
| Find all providers in EDGEWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.