Robert Moon DMD PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

DE60158372 Issued in WA

Legal business name

ROBERT MOON DMD PLLC

Practice address

309 E 2ND Ave
Ellensburg, WA 98926-3315

Phone

(509) 962-6172

NPI assigned

Feb 21, 2013

Organization subpart

No

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

Authorized official

Name

Robert Moon, DMD

Title

Dentist

Phone

(509) 750-5062

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1361404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361404800000",
    "number": "1376883702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 E 2ND AVE",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989263315",
            "telephone_number": "509-962-6172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 E 2ND AVE",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989263315",
            "telephone_number": "509-962-6172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT MOON DMD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-21",
        "last_updated": "2013-02-21",
        "status": "A",
        "authorized_official_last_name": "MOON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "509-750-5062",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60158372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Ellensburg, WA
• Providers in Ellensburg, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2013; 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.