Jimmy Joe Moon Sr., D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

13002 Issued in TX

Practice address

2009 John St
Pasadena, TX 77502-3375

Phone

(713) 473-6677

Fax

(713) 473-6778

NPI assigned

Jul 19, 2005

Last updated

Jul 14, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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.

• Jimmy Joe Moon, DDS & Barbara Seid Moon, DDS, Inc.

  • Dental Clinic/Center
  • Pasadena, TX
  • NPI 1902011307
  NPD (past) Authorized official

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247529600000",
    "number": "1629077839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2009 JOHN ST",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775023375",
            "telephone_number": "713-473-6677",
            "fax_number": "713-473-6778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2009 JOHN ST",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775023375",
            "telephone_number": "713-473-6677",
            "fax_number": "713-473-6778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "JIMMY",
        "middle_name": "JOE",
        "name_suffix": "Sr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2009-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "13002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mustak Mansur Momin, M.D.
• Clara Ruth Monroe, LPC
• Jesus Montelongo-Cortez, LPC
• Juan S. Montoya, M. D.
• Barbara Seid Moon, D.D.S
• Briana Moore, BT
• Tracy Moore
• Iris Morales Romero
• Kaylee Morales
• Maria Morales

• General Practice Dentistry in Pasadena, TX
• Providers in Pasadena, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2009; 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.