NPIMap

Organization Active NPI

Moore Dental Corporation

  • General Practice Dentistry
  • Beaumont, CA
National Provider Identifier
1174774699
Registry record updated Oct 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MOORE DENTAL CORPORATION
Practice address
1620 2ND Street Marketplace
Suite a
Beaumont, CA 92223
Phone
(951) 769-9131
NPI assigned
Oct 2, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2008

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

Authorized official

Name
Andrea Moore, DDS
Title
Owner Doctor
Phone
(951) 769-9131

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1620 2ND Street Marketplace
Suite a
Beaumont, CA 92223

Mailing address

2860 Michelle
2ND Floor
Irvine, CA 92606-1009
Phone (714) 368-2084

Other names 1

  • BEAUMONT SMILES DENTAL GROUP Doing business as

National Provider Directory

National Provider Directory

Locations

1620 E Second St
Ste A
Beaumont, CA 92223
Phone (951) 267-4167

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1222905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224460800000",
    "number": "1174774699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 MICHELLE",
            "address_2": "2ND FLOOR",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926061009",
            "telephone_number": "714-368-2084",
            "fax_number": "714-368-2092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 2ND STREET MARKETPLACE",
            "address_2": "SUITE A",
            "city": "BEAUMONT",
            "state": "CA",
            "postal_code": "92223",
            "telephone_number": "951-769-9131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOORE DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-02",
        "last_updated": "2008-10-20",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "OWNER DOCTOR",
        "authorized_official_telephone_number": "951-769-9131",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BEAUMONT SMILES DENTAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beaumont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2008; 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.