Michael Allen Moore, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901015279 Issued in MI

Practice address

9200 Greenfield Rd
Detroit, MI 48228-2202

Phone

(313) 272-6500

Fax

(313) 272-6726

NPI assigned

Oct 26, 2006

Sex

Male

Sole proprietor

No

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

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417032301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 GREENFIELD RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482282202",
            "telephone_number": "313-272-6500",
            "fax_number": "313-272-6726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 GREENFIELD RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482282202",
            "telephone_number": "313-272-6500",
            "fax_number": "313-272-6726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MICHAEL",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901015279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leandre Moore III, LLBSW
• Lindsay Diane Moore, MOT OTRL
• Lorraine Collette Moore, BSW
• Marilyn Marlena Moore
• Marquesa Luvenia Moore, MD
• Michael David Moore, M.A., L.L.P.C.
• Michael Thomas Moore, PA-C
• Michelle Lynn Moore, NP
• Monica Anne Moore, MA L.L.P.
• Moriah Jean Moore, DO

• General Practice Dentistry in Detroit, MI
• Providers in Detroit, MI by specialty
• General Practice Dentistry in Michigan

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.