Edward Herbert Moody Jr., DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DS4447 Issued in TN

Practice address

920 W Main St
Morristown, TN 37814-4515

Phone

(423) 587-1421

Fax

(423) 587-6092

NPI assigned

Jul 26, 2006

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

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.

• Edward H Moody Jr DDS PC

  • Pediatric Dentistry
  • Morristown, TN
  • NPI 1740202852
  NPD (past) Authorized official

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396769006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 W MAIN ST",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378144515",
            "telephone_number": "423-587-1421",
            "fax_number": "423-587-6092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 W MAIN ST",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378144515",
            "telephone_number": "423-587-1421",
            "fax_number": "423-587-6092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "EDWARD",
        "middle_name": "HERBERT",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TN",
            "license": "DS4447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abdelrahman H Mohamed, MD
• Pascha Moles
• Linda Gail Monteith, MD
• Amanda Montgomery, H.I.S.
• Zinamong Monzon-Benavides, DDS
• Kimberly Moore, ARNP
• Richard Bruce Moore, PA
• Sonya Glyn Moore, M.S. , LADAC II
• Dana Phillips Moreland, FNP
• Dana Morelock

• Pediatric Dentistry in Morristown, TN
• Providers in Morristown, TN by specialty
• Pediatric Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.