Michael Ralph Moore, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DN7308 Issued in FL

Practice address

410 Blanding Blvd Ste 6B
Orange Park, FL 32073-5065

Phone

(904) 276-5950

Fax

(904) 276-5359

NPI assigned

Jul 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Michael R. Moore DDS PA

  dba Southpoint Dental Care

  • General Practice Dentistry
  • Jacksonville, FL
  • NPI 1528366077
  NPD (past) Authorized official

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1184643082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7146 FITZPATRICK LN",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322262220",
            "telephone_number": "904-757-3330",
            "fax_number": "904-757-6265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 BLANDING BLVD STE 6B",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735065",
            "telephone_number": "904-276-5950",
            "fax_number": "904-276-5359"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4189 Southpoint Dr E",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322160993",
            "country_code": "US",
            "telephone_number": "904-296-3383",
            "fax_number": "904-296-3384",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MICHAEL",
        "middle_name": "RALPH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN7308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Helen S Moore, SPEECH PATHOLOGIST
• Jacob Scott Moore, DO
• John David Moore, D.C.
• Joshua Moore
• Khaleel Amir Moore
• Jyoti Moorjani, DO
• Moosehaven Inc
• Lydia Mora
• Kimberly Alejandra Morales
• Edmundo Moran, CPHT

• Dentist in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2020; 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.