Joseph M Moody, DMD
Individual provider Active NPI Dentist · Butler, AL
NPI 1043360233 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1043360233
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- AL4651 (AL)
- Practice address
- 505 E Pushmataha Street
Butler, AL 36904 - Phone
- (205) 459-5700
- Fax
- (205) 459-5701
- NPI assigned
- Jan 11, 2007
- 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 |
|---|---|---|---|
| AL4651 | AL | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | AL4651 | AL | Yes |
Addresses
Primary practice location
505 E Pushmataha Street
Butler, AL 36904
Mailing address
505 E Pushmataha Street
Butler, AL 36904
Phone (205) 459-5700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34096 | Other | AL | BCBS AL |
Other providers in Butler, AL
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.