Corey Brent Moody, D.D.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DN014924 Issued in GA

Practice address

857 Collier Rd NW Ste 5a-5B
Atlanta, GA 30318-2532

Phone

(404) 689-4140

Fax

(404) 689-4142

NPI assigned

Oct 22, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Beltway Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Atlanta, GA
  • NPI 1700484094
  NPD Authorized official

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

{
    "created_epoch": "1413936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1588068399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3424 FOX HOUND RUN",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300381605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "857 COLLIER RD NW STE 5A-5B",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303182532",
            "telephone_number": "404-689-4140",
            "fax_number": "404-689-4142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "COREY",
        "middle_name": "BRENT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-22",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "GA",
            "license": "DN014924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Azucena Montufar-Martinez
• Micaylia Moodie
• Taschecka Morvia Moodie, AGNP
• Candace E Moody, MD
• Catherine Roberts Moody, D.D.S.
• Cynthia Moody, NP
• Duane Carson Moody, FNP-C
• Jennifer Moody
• Lacey Moody, PHARMD
• Michele Lynn Moody, DOA

• Orthodontics and Dentofacial Orthopedics Dentistry in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.