Bora Moon, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

061568 Issued in NY

Practice address

2376 Broadway
New York, NY 10024-2801

Phone

(212) 686-3686

NPI assigned

Jan 10, 2021

Sex

Female

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": "1610236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610236800000",
    "number": "1346838869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EXECUTIVE DR APT 501",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070243342",
            "telephone_number": "201-736-8040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2376 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100242801",
            "telephone_number": "212-686-3686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "BORA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-10",
        "last_updated": "2021-01-10",
        "certification_date": "2021-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "061568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harsh Moolani, MD
• Colleen Moolchan, CRC, LMHC
• Maureen O'Brien Moomjy, M.D.
• Bahn Yah Moon, DDS
• Bella Su Kyung Moon
• Christine Sheila Moon, MD
• Henry Hyunsik Moon
• Jade Yunkyung Moon, MD
• James Moon
• Jang I. Moon, MD

• General Practice Dentistry in New York, NY
• Providers in New York, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2021; 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.