Dr Hazel E Moore, DDS in Kenosha, WI - Medicare Dentist Provider

Dr Hazel E Moore, DDS is a medicare enrolled "Dentist - General Practice" provider in Kenosha, Wisconsin. Her current practice location is 4536 22nd Ave, Kenosha, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (262) 656-0044.

Dr Hazel E Moore is licensed to practice in Wisconsin (license number 3267-015) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1114914066.

Contact Information

	Dr Hazel E Moore, DDS
	4536 22nd Ave, Kenosha, WI 53140-5917
	(262) 656-0044
	(262) 653-2218

Healthcare Provider's Profile

Full Name	Dr Hazel E Moore
Gender	Female
Speciality	Dentist - General Practice
Location	4536 22nd Ave, Kenosha, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1114914066
Provider Enumeration Date: 10/04/2005
Last Update Date: 12/29/2011

Medicare PECOS Information:

PECOS PAC ID: 6002112588
Enrollment ID: I20160309001169

Medical Identifiers

Medical identifiers for Dr Hazel E Moore such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1114914066	NPI	-	NPPES
33462500	Medicaid	WI

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1223G0001X	Dentist - General Practice	3267-015 (Wisconsin)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Hazel E Moore is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Hazel E Moore, DDS 5822 Charles St, Racine, WI 53402-1824 Ph: (262) 681-2085	Dr Hazel E Moore, DDS 4536 22nd Ave, Kenosha, WI 53140-5917 Ph: (262) 656-0044

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Dentist in Kenosha, WI

Jane Lynn Reyerson, DDS Dentist Medicare: Medicare Enrolled Practice Location: 7117 Green Bay Rd, Kenosha, WI 53142 Phone: 262-942-7000 Fax: 262-942-7117
Dr. Cesar D Gonzalez, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 4536 22nd Ave, Kenosha, WI 53140 Phone: 262-656-0044 Fax: 262-653-2218
Dr. David J. Crewe, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 3100 80th St, Kenosha, WI 53142 Phone: 262-694-2932 Fax: 262-694-3575
Dr. Tarah Marie Gerner, D.D.S Dentist Medicare: Medicare Enrolled Practice Location: 6226 14th Ave, Kenosha, WI 53143 Phone: 262-656-0044
Dr. Edmund Jung, Dentist Medicare: Medicare Enrolled Practice Location: 3715 Washington Rd, Kenosha, WI 53144 Phone: 262-654-6800 Fax: 262-657-9995
Dr. Jane Wright, DDS, MS Dentist Medicare: Not Enrolled in Medicare Practice Location: 7851 Cooper Rd, Kenosha, WI 53142 Phone: 262-694-5272
Jasjot Chahil, DDS Dentist Medicare: Medicare Enrolled Practice Location: 6430 Green Bay Rd, Kenosha, WI 53142 Phone: 888-988-4066

Dr Hazel E Moore, DDS - Medicare Dentist in Kenosha, WI