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Deactivated NPI 1164457636 Deactivated / Inactive NPI Male Practitioner

Dr. Douglas Robert Moss , DDS

Dentist - General Practice • Willows, CA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Douglas Moss has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 12, 2006
NPI Deactivation Date June 05, 2025
Total Practice Duration ~19 Years of Practice (2006 – 2025)

Professional Overview & Biography Verified Profile Summary

Dr. Douglas Moss, DDS was a registered Dentist - General Practice practicing in Willows, CA. Throughout an active medical career spanning 19 years, Dr. Moss provided care at the practice location at 836 W WOOD ST until profile deactivation on 2025-06-05.

Practice Location & Contact Primary Location

Practice Address

836 W Wood St

Willows, CA 959882322

Telephone 5309347720

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Willows, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 2.0 Yrs
State Avg: 21.7 Yrs
Regional Practice Density
12 Specialists

Practicing in Willows, CA (18734 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License CA 58401

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated June 05, 2025

Record deactivated on June 05, 2025

NPI Profile Active January 06, 2012

NPI status registered as active in NPPES database

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Updated Practice Location January 06, 2012

Registered at 836 W WOOD ST, WILLOWS, CA 959882322 (Tel: 5309347720)

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Updated Business Mailing Address January 06, 2012

Registered at 836 W WOOD ST, WILLOWS, CA 959882322 (Tel: 5309347720)

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Provider Name / Credentials Updated January 06, 2012

Recorded as DOUGLAS MOSS, DDS

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Medical Taxonomy / Specialty Registered (Primary Specialty) January 06, 2012

Dentist (License #58401 in CA)

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Initial NPI Registration & Enumeration July 12, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1164457636
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 12, 2006
Last Update: January 06, 2012
Deactivation Date: June 05, 2025

Mailing Address

836 W Wood St

Willows, CA 959882322

Phone: 5309347720

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.