Individual provider Active NPI

Eric S Moon, D.D.S.

  • General Practice Dentistry
  • Tomball, TX
National Provider Identifier
1366841439
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
32613 Issued in TX
Practice address
28527 State Highway 249
Tomball, TX 77375-4545
Phone
(713) 623-1122
NPI assigned
Aug 14, 2014
Last updated
Apr 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 102402 CA
General Practice Dentistry 1223G0001X 32613 TX Primary

Addresses

Primary practice location

28527 State Highway 249
Tomball, TX 77375-4545

Mailing address

8738 Banzer St
Houston, TX 77055-3110
Phone (832) 605-3383

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

LicenseStateTypeSpecialty
102402CAMDGeneral Practice Dentistry
32613TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Mai Vantage Dental PLLC General Practice CurrentSince Aug 29, 2021 Accepting new patients
HQ US Army Dental Activities Past Accepting new patients
Man Tooth Oral Services PLLC PastSince Oct 24, 2021 Accepting new patients

Locations

28527 State Highway 249
Tomball, TX 77375
Phone (713) 623-1122

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1366841439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8738 BANZER ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770553110",
            "telephone_number": "832-605-3383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28527 STATE HIGHWAY 249",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773754545",
            "telephone_number": "713-623-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "ERIC",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-14",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "102402",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "32613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tomball, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; 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.