Nicholas Jay Moore, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2019016638 Issued in MO

Practice address

525 W 32ND Street
Joplin, MO 64804

Phone

(417) 781-5600

Fax

(417) 868-8263

NPI assigned

May 21, 2019

Last updated

Aug 14, 2025By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

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

State licenses

Practice roles

Locations

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

• Advocates for a Healthy Community, Inc

  dba Jordan Valley Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Springfield, MO
  • NPI 1558303057
  Medicare reassignment NPD
• Nicholas J. Moore DDS, LLC

  • Dental Clinic/Center
  • Joplin, MO
  • NPI 1053258905
  NPD Authorized official
• Nicholas Moore DDS LLC

  • Dental Clinic/Center
  • Joplin, MO
  • NPI 1063359917
  NPD Authorized official
• Advocates for a Healthy Community Inc

  dba Jordan Valley Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Buffalo, MO
  • NPI 1750179610
  NPD
• Gregory B Kivett Jr LLC

  dba Associates of Dental Arts

  • Dental Clinic/Center
  • Joplin, MO
  • NPI 1225450075
  NPD (past)

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

{
    "created_epoch": "1558396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1225695703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 HERITAGE ACRES DRIVE",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "64801",
            "telephone_number": "816-699-0732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 W 32ND STREET",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "64804",
            "telephone_number": "417-781-5600",
            "fax_number": "417-868-8263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "NICHOLAS",
        "middle_name": "JAY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-21",
        "last_updated": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2019016638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI PROFESSIONAL LICENSE",
            "identifier": "2019016638",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacob A Moore
• Jennifer Beth Moore, CRNP
• Lukas Moore
• Melissa L Moore, LMSW
• Melissa L Moore I, MSW, PLCSW
• Thomas B. Moore, M.D.
• Toby G Moore, D.O.
• Trent Moore, DPT
• Winter N Moore
• Roberto Antonio Moran-Bojorquez, M.D.

• Dentist in Joplin, MO
• Providers in Joplin, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2025; 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.