Provider record
Kenneth J Moran DDS
Use this page to review the CMS NPPES listing for Kenneth J Moran DDS: Oral And Maxillofacial Surgery (dentist), individual entity type, practice location in Tuba City, AZ, and source checked date. Confirm details directly with the provider.
National Plan and Provider Enumeration System
CMS NPPES
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We show source-reported CMS NPPES fields.
Confirm details directly with the provider.NPI and status
Source-labeled identifiers and reported record state.
- NPI
- 1548200256
- Entity type
- Individual
- NPPES status
- Reported active
- License status
- Not primary-source verified
Practice location
Practice address and phone as reported in CMS NPPES.
- Address
- 167 North Main Street
Tuba City, AZ 86045-0600 - Phone
- (928) 283-2501
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Taxonomy and source
Specialty taxonomy is source-reported and not a quality or license determination.
- Taxonomy code
- 1223S0112X
- Specialty
- Oral and Maxillofacial Surgery (Dentist)
- Source
- CMS NPPES
- Last updated
- July 12, 2026
Record actions
Contact and sources
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