Keith Erickson Moore, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN11491 Issued in FL

Practice address

901 S Federal Hwy
Ste 301
Ft Lauderdale, FL 33316-1266

Phone

(954) 768-1981

NPI assigned

Jun 13, 2016

Sex

Male

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465776000000",
    "number": "1336599141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 S FEDERAL HWY",
            "address_2": "STE 301",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333161266",
            "telephone_number": "954-768-1981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 S FEDERAL HWY",
            "address_2": "STE 301",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333161266",
            "telephone_number": "954-768-1981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KEITH",
        "middle_name": "ERICKSON",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-13",
        "last_updated": "2016-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN11491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andromeda Moodie, LMFT
• Harry K. Moon, M.D.
• Savannah Moon, D.O.
• January Moore
• Julie Isabella Moore, LMFT
• Martha F Moore, L.M.T.
• Ronald E Moore Jr., MD
• Roosevelt Moore, RPT
• Taryll Leon Moore Jr.
• Theola Moore, MS, MHC

• General Practice Dentistry in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2016; 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.