Grace Elizabeth Moore, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

032763 Issued in IL

Practice address

1610 W Fullerton Ave
Chicago, IL 60614-2659

Phone

(630) 423-9646

NPI assigned

Jul 16, 2020

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1594857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1235747171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "361 MILLRIDGE DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462901117",
            "telephone_number": "317-371-0555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606142659",
            "telephone_number": "630-423-9646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "GRACE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-16",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "032763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@atooth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1610 W Fullerton Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606142659",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Eathel Antoinette Moore, CNA
• Emilee Lane Moore, OTD, OTR/L
• Emily A Moore, CT
• Emily Marie Moore, M.A.
• Erica Moore
• Hannah Moore
• Helene Darlak Moore, PSY.D.
• Henry Dunbar Moore, D.D.S.
• Jacob Robert Moore, M.D.
• Janaan Schmuhl Moore, AU.D.

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2020; 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.