Gene P Moore, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

20419 Issued in CA

Practice address

286 Euclid Ave Ste 201
San Diego, CA 92114-3612

Phone

(619) 263-6683

Fax

(619) 263-0048

NPI assigned

Nov 16, 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• Gene P. Moore DDS

  • General Practice Dentistry
  • San Diego, CA
  • NPI 1154442911
  NPD (past) Authorized official
• Western Dental Services, Inc.

  • Dentist
  • San Diego, CA
  • NPI 1114578580
  NPD (past)

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466467200000",
    "number": "1457424699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "286 EUCLID AVE STE 201",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921143612",
            "telephone_number": "619-263-6683",
            "fax_number": "619-263-0048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "286 EUCLID AVE STE 201",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921143612",
            "telephone_number": "619-263-6683",
            "fax_number": "619-263-0048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "GENE",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2016-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "20419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL",
            "identifier": "B20419 01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Courtney Diane Moore, RADT
• Darryl Kenneth Moore, PHD
• Donald Joe Moore, M.D.
• Eileen Moore
• Fiona Moore
• Grace Moore
• Heathcliffe Moore
• Heather Grace Moore, FNP-BC
• Hugh E. Moore, RN
• Ian H. Moore, N.D.

• General Practice Dentistry in San Diego, CA
• Providers in San Diego, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2016; 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.