Blakely Moore, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4854 Issued in AR

Practice address

550 Chestnut St
Conway, AR 72032-5402

Phone

(501) 329-8754

NPI assigned

Jun 10, 2025

Sex

Female

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)

Not enrolled

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

{
    "created_epoch": "1749513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1225923287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 MAGNESS CREEK DR",
            "city": "CABOT",
            "state": "AR",
            "postal_code": "720238723",
            "telephone_number": "501-658-9596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 CHESTNUT ST",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720325402",
            "telephone_number": "501-329-8754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "BLAKELY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-10",
        "last_updated": "2025-06-10",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "4854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Montrose
• Jamie Moody, M.S. CCC-SLP
• Steven Moon, RECOVERY ASSISTANT
• Alyndria Mooney
• Jennifer Mooney
• Jennifer Moore
• Leslie Moore, PHARM.D.
• Richard Eugene Moore, M.D.
• Steven Moore, MHPP
• Zane Moore, D.P.M

• General Practice Dentistry in Conway, AR
• Providers in Conway, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2025; 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.