Active NPI
Robert M Moodydds/ Eureka
- General Practice Dentistry
- Eureka, KS
National Provider Identifier
1265624712
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Legal business name
- ROBERT M MOODYDDS/ EUREKA
- Practice address
- 302 W 3Rd St
Eureka, KS 67045-1404 - Phone
- (620) 583-7489
- Fax
- (620) 583-7489
- NPI assigned
- Aug 17, 2007
- Organization subpart
- Yes
- Parent organization
- ROBERT M. MOODY/EL DORADO
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Robert M Moody, DDS
- Title
- Owner/Dentist
- Phone
- (620) 583-7489
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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | Primary |
Addresses
Primary practice location
302 W 3Rd St
Eureka, KS 67045-1404
Mailing address
302 W 3Rd St
Eureka, KS 67045-1404
Phone (620) 583-7489
National Provider Directory
National Provider Directory- Tax ID family
- RM Moodyddsel Dorado
- Part of
- RM Moodyddsel Dorado
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- General Practice Dentistry
- El Dorado, KS
- NPI 1902098452
Locations
302 W 3rd St
Eureka, KS 67045
Phone (620) 583-7489
Practitioners & affiliated clinicians
Practitioners 1
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": "1187308800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1187308800000",
"number": "1265624712",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "302 W 3RD ST",
"city": "EUREKA",
"state": "KS",
"postal_code": "670451404",
"telephone_number": "620-583-7489",
"fax_number": "620-583-7489"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "302 W 3RD ST",
"city": "EUREKA",
"state": "KS",
"postal_code": "670451404",
"telephone_number": "620-583-7489",
"fax_number": "620-583-7489"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ROBERT M MOODYDDS/ EUREKA",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "ROBERT M. MOODY/EL DORADO",
"enumeration_date": "2007-08-17",
"last_updated": "2007-08-17",
"status": "A",
"authorized_official_last_name": "MOODY",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "OWNER/DENTIST",
"authorized_official_telephone_number": "620-583-7489",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eureka, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.