Reginald Ivory Moore, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

27343 Issued in CA

Practice address

22675 Alessandro Blvd
Moreno Valley, CA 92553-8551

Phone

(951) 571-2300

NPI assigned

Apr 23, 2007

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320105600000",
    "number": "1184842262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19920 AVENIDA DESEO",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917892210",
            "telephone_number": "951-836-9181",
            "fax_number": "909-598-5995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22675 ALESSANDRO BLVD",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925538551",
            "telephone_number": "951-571-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "REGINALD",
        "middle_name": "IVORY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2011-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "27343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Moore, DO
• Erin Elizabeth Moore, M.S.
• Kayla Moore
• Marjani Moore, MS, RD
• Rebecca Jean Horspool Moore
• Melissa Patricia Cerdeno Moquin, FNP-C
• Ana Alejandra Morales
• Anthony Morales
• Gina Morales, LCSW
• Maria Morales, LVN

• General Practice Dentistry in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.