NPIMap

Organization Active NPI

Jeffrey W Moore DDS PA

  • General Practice Dentistry
  • Richardson, TX
National Provider Identifier
1003901661
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14959 Issued in TX
Legal business name
JEFFREY W MOORE DDS PA
Practice address
4011 E. Renner Road
Suite #107
Richardson, TX 75082-2917
Phone
(972) 238-5665
Fax
(972) 238-5765
NPI assigned
Oct 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Jeffrey W Moore, D.D.S.NPI 1295991529
Title
President
Phone
(972) 238-5665

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 14959 TX Primary

Addresses

Primary practice location

4011 E. Renner Road
Suite #107
Richardson, TX 75082-2917

Mailing address

4011 E. Renner Road
Suite #107
Richardson, TX 75082-2917
Phone (972) 238-5665

Other names 1

  • North Star Dental Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003901661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4011 E. RENNER ROAD",
            "address_2": "SUITE #107",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750822917",
            "telephone_number": "972-238-5665",
            "fax_number": "972-238-5765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4011 E. RENNER ROAD",
            "address_2": "SUITE #107",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750822917",
            "telephone_number": "972-238-5665",
            "fax_number": "972-238-5765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY W MOORE DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-238-5665",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "14959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Star Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Richardson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.