NPIMap

Organization Active NPI

Justin David Moody, DDS, a Professional Corporation

  • Dentist
  • El Cajon, CA
National Provider Identifier
1437664331
Registry record updated Dec 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
JUSTIN DAVID MOODY, DDS, A PROFESSIONAL CORPORATION
Practice address
181 Fletcher Pkwy
El Cajon, CA 92020-2525
Phone
(619) 441-0701
NPI assigned
Dec 13, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2017

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

Authorized official

Name
Justin Moody, DDS
Title
Practice Owner
Phone
(619) 441-0701

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

181 Fletcher Pkwy
El Cajon, CA 92020-2525

Mailing address

181 Fletcher Pkwy
El Cajon, CA 92020-2525
Phone (619) 441-0701

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1513123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513123200000",
    "number": "1437664331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 FLETCHER PKWY",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920202525",
            "telephone_number": "619-441-0701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 FLETCHER PKWY",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920202525",
            "telephone_number": "619-441-0701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUSTIN DAVID MOODY, DDS, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-13",
        "last_updated": "2017-12-13",
        "status": "A",
        "authorized_official_last_name": "MOODY",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "PRACTICE OWNER",
        "authorized_official_telephone_number": "619-441-0701",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Cajon, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2017; 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.