Ryan Moore, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3843 Issued in AR

Practice address

811 Clinton St
Arkadelphia, AR 71923-5923

Phone

(870) 246-2221

Fax

(870) 246-2532

NPI assigned

Jul 14, 2011

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

Other identifiers 2

Other names 1

• Dr. Ryan Moore Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Ryan a Moore DDS, PLLC

  • Dentist
  • Arkadelphia, AR
  • NPI 1306291984
  NPD (past) Authorized official

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

{
    "created_epoch": "1310601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518566400000",
    "number": "1386932143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 CLINTON ST",
            "city": "ARKADELPHIA",
            "state": "AR",
            "postal_code": "719235923",
            "telephone_number": "870-246-2221",
            "fax_number": "870-246-5923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 CLINTON ST",
            "city": "ARKADELPHIA",
            "state": "AR",
            "postal_code": "719235923",
            "telephone_number": "870-246-2221",
            "fax_number": "870-246-2532"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8116 Cantrell Rd",
            "address_2": "Suite C",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722272421",
            "country_code": "US",
            "telephone_number": "501-227-5200",
            "fax_number": "501-227-5849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-14",
        "last_updated": "2018-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21305563",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "188398608",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RYAN",
            "last_name": "MOORE",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Alexandra Mitchell, APRN
• Ali Rene Mitchell, DO
• Cali Marie Montgomery
• Jocelyn Amanda Moody, ATC
• Emily Moore
• Hannah More
• Carol Morgan, M.S. CCC-SLP
• Willica Etisha Morgan, MS, LPC
• Christa Marie Morrison
• Madison Deann Morrow

• General Practice Dentistry in Arkadelphia, AR
• Providers in Arkadelphia, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2018; 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.