NPIMap

Organization Active NPI

Brent W. Moody D.D.S., PC

  • Pediatric Dentistry
  • Oklahoma City, OK
National Provider Identifier
1225202138
Registry record updated Apr 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
5120 Issued in OK
Legal business name
BRENT W. MOODY D.D.S., PC
Practice address
4320 McAuley Blvd
Oklahoma City, OK 73120-8386
Phone
(405) 755-8020
NPI assigned
Apr 22, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2008

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

Authorized official

Name
Dr. Brent W. Moody, D.D.S.
Title
President
Phone
(405) 755-8020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 5120 OK Primary

Addresses

Primary practice location

4320 McAuley Blvd
Oklahoma City, OK 73120-8386

Mailing address

4320 McAuley Blvd
Oklahoma City, OK 73120-8386
Phone (405) 755-8020

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208822400000",
    "number": "1225202138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4320 MCAULEY BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208386",
            "telephone_number": "405-755-8020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 MCAULEY BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208386",
            "telephone_number": "405-755-8020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENT W. MOODY D.D.S., PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-22",
        "last_updated": "2008-04-22",
        "status": "A",
        "authorized_official_last_name": "MOODY",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "405-755-8020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OK",
            "license": "5120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.