Individual provider Active NPI

Kara Griffin Moore, D.M.D.

  • General Practice Dentistry
  • Gray, GA
National Provider Identifier
1295746501
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13080 Issued in GA
Practice address
242 W Clinton St
Gray, GA 31032-5430
Phone
(478) 986-6821
Fax
(478) 986-3253
NPI assigned
Aug 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 13080 GA Primary

Addresses

Primary practice location

242 W Clinton St
Gray, GA 31032-5430

Mailing address

PO Box 670
Gray, GA 31032-0670
Phone (478) 986-6821

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20141014001215 GA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9335360437

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13080GAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Gray Dental Associates, P.C. General Practice Past Accepting new patients
Gray Dental Associates General Practice Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295746501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 670",
            "city": "GRAY",
            "state": "GA",
            "postal_code": "310320670",
            "telephone_number": "478-986-6821",
            "fax_number": "478-986-3253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 W CLINTON ST",
            "city": "GRAY",
            "state": "GA",
            "postal_code": "310325430",
            "telephone_number": "478-986-6821",
            "fax_number": "478-986-3253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KARA",
        "middle_name": "GRIFFIN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "13080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gray, GA

Sources for this page

Verify at the official NPI Registry.