Dr. Kerry Moon, D.D.S., PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

DR. KERRY MOON, D.D.S., PLLC

Practice address

2501 Crestwood Rd Ste 201
North Little Rock, AR 72116-7616

Phone

(501) 758-5006

NPI assigned

Apr 6, 2022

Last updated

Apr 6, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kery Moon, DDS

Title

Owner Dentist

Phone

(501) 281-5347

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kerry Moon

  • General Practice Dentistry
  • North Little Rock, AR
  • NPI 1588274757
  NPD
• Van S O'Dell, DDS

  • General Practice Dentistry
  • N Little Rock, AR
  • NPI 1295845139
  NPD (past)

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

{
    "created_epoch": "1649203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649203200000",
    "number": "1013658681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 WILLOW ST",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721144637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 CRESTWOOD RD STE 201",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721167616",
            "telephone_number": "501-758-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. KERRY MOON, D.D.S., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-06",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A",
        "authorized_official_last_name": "MOON",
        "authorized_official_first_name": "KERY",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "501-281-5347",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "243554608",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dr Perry L Amerine PA (Amerine Eye Care)
• Dr Phillip Jaros PA
• Dr Q Pain & Spine Clinic, PA (ASAP Family Medicine Clinic)
• Dr. Bryant Ashley, Jr.
• Dr. Dennis L. Wingfield, PA
• Dr. Kevin M Dugan D,D,S P.a
• Dr. Paul Dean, D.D.S., P.a.
• Dr. Shaker LTD. (Central Arkansas Access Center)
• Adrienne A'Della Dredd
• Hannah Elizabeth Dresser, RD

• Dental Clinic/Center in North Little Rock, AR
• Providers in North Little Rock, AR by specialty
• Dental Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; 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.