Jon Y. Moody, DDS
Individual provider Active NPI General Practice Dentistry · Fillmore, UT
NPI 1023025939 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1023025939
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 02670-0701-7 (UT)
- Practice address
- 55 S Main
#3
Fillmore, UT 84631 - Phone
- (435) 743-6178
- Fax
- (435) 743-6178
- NPI assigned
- Aug 2, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02670-0701-7 | UT | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 02670-0701-7 | UT | Yes |
Addresses
Primary practice location
55 S Main
#3
Fillmore, UT 84631
Mailing address
55 S Main
#3
Fillmore, UT 84631
Phone (435) 743-6178
Other providers in Fillmore, UT
- Jacob D Finlinson, D.D.S, LLC
- Tonia Jorgensen
- Randleman Pearsall Keltner
- Shianna Markward
- Leona Mae Moat
- Jana Lynn Orton
- Heather Marie Rasmussen
- Taylor Roberts
- Merla Rutherford
- Service Drug Company Inc
All providers in Fillmore, UT · General Practice Dentistry in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.