Duane Stephen Moore, DENTIST

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE00008271 Issued in WA

Practice address

2026 Olympic Hwy N
Suite 101
Shelton, WA 98584-4156

Phone

(360) 432-8379

Fax

(360) 432-0526

NPI assigned

Feb 22, 2007

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1467587329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2026 OLYMPIC HWY N",
            "address_2": "SUITE 101",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985844156",
            "telephone_number": "360-432-8379",
            "fax_number": "360-432-0526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2026 OLYMPIC HWY N",
            "address_2": "SUITE 101",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985844156",
            "telephone_number": "360-432-8379",
            "fax_number": "360-432-0526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "DUANE",
        "middle_name": "STEPHEN",
        "credential": "DENTIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00008271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5045075",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alex Mills
• Akashia Milsap
• Debra Moffitt, L.M.P.
• Matthew Todd Moody, DO
• Donald E Moon, MA LMHCA
• Naomi Elizabeth Mork, OTR/L
• Mark Alexander Morris, MSW, LSWAIC
• Vince Edward Morson, DC
• Amber Morton, SUDP/T
• Amie Elise Freeman Mower, D.O.

• General Practice Dentistry in Shelton, WA
• Providers in Shelton, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.