Active NPI
Grace Dental Care PC
- General Practice Dentistry
- Madison, TN
National Provider Identifier
1013182849
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Legal business name
- GRACE DENTAL CARE PC
- Practice address
- 500 Lentz Dr Ste 60
Madison, TN 37115-5135 - Phone
- (615) 612-1740
- Fax
- (615) 612-1751
- NPI assigned
- Apr 23, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Young Jin Moon, D.M.D.
- Title
- Owner
- Phone
- (615) 612-1740
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) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | TN | Primary |
Addresses
Primary practice location
500 Lentz Dr Ste 60
Madison, TN 37115-5135
Mailing address
500 Lentz Dr
Suite 60
Madison, TN 37115-5135
Phone (615) 612-1740
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q017107 | Medicaid | TN |
Other names 1
- CORNERSTONE DENTAL CARE PC
National Provider Directory
National Provider DirectoryLocations
500 Lentz Dr
Ste 60
Madison, TN 37115
Phone (615) 612-1740
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- General Practice Dentistry
- Madison, TN
- NPI 1477759546
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208908800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1761177600000",
"number": "1013182849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 LENTZ DR",
"address_2": "SUITE 60",
"city": "MADISON",
"state": "TN",
"postal_code": "371155135",
"telephone_number": "615-612-1740",
"fax_number": "615-612-1751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 LENTZ DR STE 60",
"city": "MADISON",
"state": "TN",
"postal_code": "371155135",
"telephone_number": "615-612-1740",
"fax_number": "615-612-1751"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GRACE DENTAL CARE PC",
"organizational_subpart": "NO",
"enumeration_date": "2008-04-23",
"last_updated": "2025-10-23",
"certification_date": "2025-10-23",
"status": "A",
"authorized_official_last_name": "MOON",
"authorized_official_first_name": "YOUNG",
"authorized_official_middle_name": "JIN",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "615-612-1740",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.M.D."
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "TN",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Q017107",
"state": "TN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CORNERSTONE DENTAL CARE PC",
"code": "4",
"type": "Former Legal Business Name"
},
{
"organization_name": "CORNERSTONE DENTAL CARE PC",
"code": "4",
"type": "Former Legal Business Name"
}
]
}Other providers in Madison, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.