Moore Dental at Lewis Center

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

30.023482 Issued in OH

Legal business name

MOORE DENTAL AT LEWIS CENTER

Practice address

6421 Pullman Dr
Lewis Center, OH 43035-7377

Phone

(740) 548-5100

NPI assigned

Jun 23, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Clifford W Moore, D.D.S.

Title

Owner

Phone

(419) 603-0236

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1435017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435017600000",
    "number": "1104208594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6421 PULLMAN DR",
            "city": "LEWIS CENTER",
            "state": "OH",
            "postal_code": "430357377",
            "telephone_number": "740-548-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6421 PULLMAN DR",
            "city": "LEWIS CENTER",
            "state": "OH",
            "postal_code": "430357377",
            "telephone_number": "740-548-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOORE DENTAL AT LEWIS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-23",
        "last_updated": "2015-06-23",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "CLIFFORD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-603-0236",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OH",
            "license": "30.023482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelbey M Mitchell, MSW, LISW-S
• Modern Medical Inc
• Iman Mohamed, RN
• Cynthia Montgomery
• Robyn Montgomery
• John Richard Moore, D.C.
• Zoe Moore
• Tyler Morman, DC
• Heather Marie Mousie, FNP-C
• Mr Per Copy, LLC

• Dental Clinic/Center in Lewis Center, OH
• Providers in Lewis Center, OH by specialty
• Dental Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2015; 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.