NPIMap

Individual provider Active NPI

Richard Wallace Moore, DDS

  • Dentist
  • Tigard, OR
National Provider Identifier
1487701942
Registry record updated Dec 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D5689 Issued in OR
Practice address
10220 SW Greenburg Road
Suite 150
Tigard, OR 97223-5529
Phone
(503) 255-1200
Fax
(503) 408-6856
NPI assigned
Jan 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D5689 OR Primary

Addresses

Primary practice location

10220 SW Greenburg Road
Suite 150
Tigard, OR 97223-5529

Mailing address

10220 SW Greenburg Road
Suite 150
Tigard, OR 97223-5529
Phone (503) 255-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D5689ORMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Richard W. Moore DDS PC PastSince Jan 1, 2009 Accepting new patients
Sleep Medicine Group LLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324252800000",
    "number": "1487701942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10220 SW GREENBURG ROAD",
            "address_2": "SUITE 150",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972235529",
            "telephone_number": "503-255-1200",
            "fax_number": "503-408-6856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10220 SW GREENBURG ROAD",
            "address_2": "SUITE 150",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972235529",
            "telephone_number": "503-255-1200",
            "fax_number": "503-408-6856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "RICHARD",
        "middle_name": "WALLACE",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-05",
        "last_updated": "2011-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D5689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2011; 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.