BG Moore, DDS, PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

BG MOORE, DDS, PA

Practice address

1720 Abbey PL
Ste 1
Charlotte, NC 28209-3736

Phone

(704) 525-9818

NPI assigned

Oct 11, 2022

Organization subpart

No

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

Authorized official

Name

Amy Scoggins

Title

Office Manager

Phone

(704) 342-3213

Specialties & licenses 1

Addresses

Other names 1

• Willow Oak Dental Doing business as

Locations

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

{
    "created_epoch": "1665446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665446400000",
    "number": "1497470538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 ABBEY PL",
            "address_2": "STE 1",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282091546",
            "telephone_number": "704-525-9818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 ABBEY PL",
            "address_2": "STE 1",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093736",
            "telephone_number": "704-525-9818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BG MOORE, DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-11",
        "last_updated": "2022-10-11",
        "certification_date": "2022-09-19",
        "status": "A",
        "authorized_official_last_name": "SCOGGINS",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "704-342-3213"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Willow Oak Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Charlotte, NC
• Providers in Charlotte, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2022; 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.