MOONLIGHT ORAL SURGERY PLLC (NPI# 1487271334) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487271334 |
| Entity Type | Organization |
| Organization Name | MOONLIGHT ORAL SURGERY PLLC |
| Practice Address |
1210 S Glebe Rd Unit 40580 Arlington VA 22204-0282 |
| Practice Telephone | 4085068919 |
| Mailing Telephone | 4085068919 |
| Enumeration Date | 2020-06-26 |
| Last Update Date | 2020-06-26 |
| Authorized Official Name | DR. RYAN PATEL (OWNER) |
| Authorized Official Telephone | 4085068919 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers |
| Street Address |
1210 S GLEBE RD UNIT 40580 |
| City | ARLINGTON |
| State | VA |
| Zip Code | 22204-0282 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639714157 | Cielito Home Health Services, LLC | Registered Nurse | 3708 3rd. Street South, Arlington, VA 22204 | 2019-11-07 |
| 1275177438 | Annie Rachel Poole | Occupational Therapist | 2301 Columbia Pike, Suite 125, Arlington, VA 22204 | 2019-10-31 |
| 1609426436 | Daniela Patricia Jaldin | Home Health Aide | 3708 3rd St. South, Arlington, VA 22204 | 2019-09-13 |
| 1124581475 | Lisa Nemeth | Psychologist | 2110 Washington Bvld, Office of Student Services, Arlington, VA 22204 | 2019-04-12 |
| 1568946176 | Barcroft Dentistry | Dentist | 939 S. Wakefield St, Arlington, VA 22204 | 2018-09-19 |
| 1316431869 | Shannon Odom | Psychologist | Arlington Public Schools Child Find, 2110 Washington Blvd, Arlington, VA 22204 | 2018-06-19 |
| 1801301106 | Carla Janai Farley | Behavior Technician | 2726 N. Cleveland Street, Arlington, VA 22204 | 2017-12-08 |
| 1174064737 | Ezequiel Andrade Fuentes | Dentist | Calle Segunda #67, Ejido Mariano Matamoros, Tijuana, BAJA CALIFORNIA 22204 | 2017-03-15 |
| 1639583107 | Syeda Kutub | Optometrist | 1020 S Glebe Rd, Arlington, VA 22204 | 2014-06-12 |
| 1255769311 | Joyful Mind Counseling of Virginia | Home Health | 1804 B 9th St South, Arlington, VA 22204 | 2013-10-28 |
| Find all providers in zip 22204 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932716859 | Gentle Dentistry Inc | Dentist | 1810 S Bowen Rd Ste A, Arlington, TX 76013-3340 | 2020-09-24 |
| 1295348720 | Virginia Plastic Surgery Institute | Dentist | 1016 N Highland St Ste 131b, Arlington, VA 22201-2112 | 2020-08-25 |
| 1184091340 | I-20 Oral Surgery Pllc | Dentist | 2200 W I 20, Suite 300, Arlington, TX 76017-1648 | 2015-08-24 |
| 1235526328 | Ryan Patel | Dentist | 1340 S Rolfe St, Arlington, VA 22204-4750 | 2015-04-16 |
| 1306067004 | James Hadley Hall | Dentist | 2304 Interstate 20 W, #150, Arlington, TX 76017-1668 | 2007-05-01 |
| 1548328222 | Paul Edward Menton | Dentist | 847 W Mitchell St, Arlington, TX 76013-2506 | 2006-12-05 |
| 1306915673 | John V Shroyer | Dentist | 2712 Matlock Rd, Arlington, TX 76015 | 2006-11-08 |
| 1215919337 | Haroon Ismaili | Dentist | 2304 W Interstate 20, Suite 150, Arlington, TX 76017-1668 | 2005-11-15 |
| 1306842273 | Stephen C Walters | Dentist | 2200 West Interstate 20, Suite 300, Arlington, TX 76017 | 2005-06-24 |
| 1538572961 | Paul E Menton Dds Inc | Dentist | 847 W Mitchell St, Arlington, TX 76013-2506 | 2014-06-03 |
| Find all providers in ARLINGTON | ||||
Please comment or provide details below to improve the information on MOONLIGHT ORAL SURGERY PLLC.
| 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.