Active NPI
Ernest Houston Moore, D.D. S.
- Dentist
- Mabank, TX
National Provider Identifier
1619087558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 8211
- Practice address
- 302 N 3Rd St
Mabank, TX 75147-8611 - Phone
- (903) 887-4405
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 8211 | TX | Primary |
Addresses
Primary practice location
302 N 3Rd St
Mabank, TX 75147-8611
Mailing address
9545 FM 1836
Kaufman, TX 75142-6930
Phone (972) 962-6388
Other practice location 1
505 S Washington St Ste A
Kaufman, TX 75142-2472
Phone (972) 962-6388
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, WV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160401001681 | TX | Order and Referring Only - Dentist | 2062719214 | |
| I20241105000128 | WV | Order and Referring Only - Dentist | 2062719214 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mabank Family Dentistry PLLC | General Practice | Past | Accepting new patients |
| Clayton a Gautreaux D.D.S | General Practice | 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": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665100800000",
"number": "1619087558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9545 FM 1836",
"city": "KAUFMAN",
"state": "TX",
"postal_code": "751426930",
"telephone_number": "972-962-6388",
"fax_number": "214-368-8810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "302 N 3RD ST",
"city": "MABANK",
"state": "TX",
"postal_code": "751478611",
"telephone_number": "903-887-4405"
}
],
"practiceLocations": [
{
"address_1": "505 S Washington St Ste A",
"address_purpose": "LOCATION",
"city": "Kaufman",
"state": "TX",
"postal_code": "751422472",
"country_code": "US",
"telephone_number": "972-962-6388",
"fax_number": "214-368-8810",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOORE",
"first_name": "ERNEST",
"middle_name": "HOUSTON",
"name_prefix": "Dr.",
"credential": "D.D. S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2022-10-07",
"certification_date": "2022-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "8211",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mabank, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.