NPIMap

Organization Active NPI

Moore Dental Services, Inc

Doing business as Dental Development Center

  • Dentist
  • Florence, KY
National Provider Identifier
1205968120
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
MOORE DENTAL SERVICES, INC
Doing business as
Dental Development Center
Practice address
59 Cavalier Blvd
300
Florence, KY 41042
Phone
(859) 525-0507
Fax
(859) 525-0610
NPI assigned
Mar 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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

Authorized official

Name
Martin Joseph MooreNPI 1225306483
Title
Pres
Phone
(859) 371-4422

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X

Addresses

Primary practice location

59 Cavalier Blvd
300
Florence, KY 41042

Mailing address

59 Cavalier Blvd
300
Florence, KY 41042
Phone (859) 525-0507

Other practice location 1

6961 Burlington Pike
Florence, KY 41042-1618
Phone (859) 371-4422

Other identifiers 1

IdentifierTypeStateIssuer
1225306483MedicaidKY

Other names 1

  • DENTAL DEVELOPMENT CENTER Doing business as

National Provider Directory

National Provider Directory

Locations

59 Cavalier Blvd
Ste 300
Florence, KY 41042
Phone (859) 525-0507

Practitioners & affiliated clinicians

Practitioners 5

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": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611014400000",
    "number": "1205968120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 CAVALIER BLVD",
            "address_2": "300",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "41042",
            "telephone_number": "859-525-0507",
            "fax_number": "859-525-0610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 CAVALIER BLVD",
            "address_2": "300",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "41042",
            "telephone_number": "859-525-0507",
            "fax_number": "859-525-0610"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6961 Burlington Pike",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "KY",
            "postal_code": "410421618",
            "country_code": "US",
            "telephone_number": "859-371-4422",
            "fax_number": "859-282-5482",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MOORE DENTAL SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "859-371-4422"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225306483",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DENTAL DEVELOPMENT CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Florence, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; 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.