Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1891825162 Deactivated / Inactive NPI Male Practitioner

Dr. Jacob Haskell Moberly , DDS

Dentist • Clovis, NM

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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. Jacob Moberly has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date March 06, 2007
NPI Deactivation Date December 20, 2020
Total Practice Duration ~13 Years of Practice (2007 – 2020)

Professional Overview & Biography Verified Profile Summary

Dr. Jacob Moberly, DDS was a registered Dentist practicing in Clovis, NM. Throughout an active medical career spanning 13 years, Dr. Moberly provided care at the practice location at 2000 W 21ST ST until profile deactivation on 2020-12-20.

Practice Location & Contact Primary Location

Practice Address

2000 W 21st St
Ste L1

Clovis, NM 881014087

Telephone 5057620986
Fax 5057630418
Associated Practice Facility / Clinic
🏢 Women's Medical Center Llp Facility NPI 1780683292

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Clovis, NM

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 12.6 Yrs
Regional Practice Density
20 Specialists

Practicing in Clovis, NM (630 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 Primary Specialty

NUCC Taxonomy Code: 122300000X

State License NM 701

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
NPI 1013369503

TECHNICIANOTHER

Ivonne Gonzalez-Reyes

Behavior Technician

NPI 1104687003
Tiffany Bowers

Behavior Technician

NPI 1124837356
Schyler Baca

Behavior Technician

NPI 1134980568
Shelby Conner

Behavior Technician

NPI 1154219459
Cadance Romero

Behavior Technician

NPI 1184506321

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 December 20, 2020

Record deactivated on December 20, 2020

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 2000 W 21ST ST, STE L1, CLOVIS, NM 881014087 (Tel: 5057620986)

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Updated Business Mailing Address July 08, 2007

Registered at 2000 W 21ST ST, STE L1, CLOVIS, NM 881014087 (Tel: 5057620986)

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Provider Name / Credentials Updated July 08, 2007

Recorded as JACOB MOBERLY, DDS

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #701 in NM)

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Initial NPI Registration & Enumeration March 06, 2007

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: 1891825162
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 06, 2007
Last Update: July 08, 2007
Deactivation Date: December 20, 2020

Mailing Address

2000 W 21st St, Ste L1

Clovis, NM 881014087

Phone: 5057620986

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.