Kerry Moon

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4453 Issued in AR

Practice address

520 W Pershing Blvd
North Little Rock, AR 72114-2148

Phone

(501) 753-2800

NPI assigned

Aug 3, 2020

Last updated

Aug 3, 2020By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dr. Kerry Moon, D.D.S., PLLC

  • Dental Clinic/Center
  • North Little Rock, AR
  • NPI 1013658681
  NPD

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

{
    "created_epoch": "1596412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1588274757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 WILLOW ST",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721144637",
            "telephone_number": "501-281-5347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 W PERSHING BLVD",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721142148",
            "telephone_number": "501-753-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "KERRY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-03",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "4453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Summer Lynn Mojica, PA
• Michael F Moll
• Adam Montgomery, PHARM.D.
• Mary Louise Montgomery, B.S.
• Maurice Moody
• Stacey Moon, APRN, MNSC, AGACNPBC
• Scott Ryan Mooney, PHD, ABPP
• Tiffany V Mooney, OD
• Aislinn Moore
• Breanna Kishay Moore

• General Practice Dentistry in North Little Rock, AR
• Providers in North Little Rock, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; 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.