Active NPI
Betty Dillon, DDS
- Dentist
- Stone Mountain, GA
National Provider Identifier
1275676389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0011434
- Practice address
- 900 N Hairston Rd
Suite B
Stone Mountain, GA 30083-2857 - Phone
- (404) 294-8500
- Fax
- (404) 294-4844
- NPI assigned
- Feb 15, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 0011434 | GA | Primary |
Addresses
Primary practice location
900 N Hairston Rd
Suite B
Stone Mountain, GA 30083-2857
Mailing address
900 N Hairston Rd
Suite B
Stone Mountain, GA 30083-2857
Phone (404) 294-8500
Other names 1
- Dr. Betty Dillon-Moore
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0011434 | GA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1275676389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 N HAIRSTON RD",
"address_2": "SUITE B",
"city": "STONE MOUNTAIN",
"state": "GA",
"postal_code": "300832857",
"telephone_number": "404-294-8500",
"fax_number": "404-294-4844"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 N HAIRSTON RD",
"address_2": "SUITE B",
"city": "STONE MOUNTAIN",
"state": "GA",
"postal_code": "300832857",
"telephone_number": "404-294-8500",
"fax_number": "404-294-4844"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DILLON",
"first_name": "BETTY",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-15",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "GA",
"license": "0011434",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "BETTY",
"last_name": "DILLON-MOORE",
"prefix": "DR.",
"credential": "DDS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Stone Mountain, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.