Active NPI
Paul T Moore, DMD
- Dentist
- Damascus, VA
National Provider Identifier
1639238264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0401008807
- Practice address
- 306 South Shady Ave.
Damascus, VA 24236 - Phone
- (276) 475-5116
- Fax
- (276) 475-5665
- NPI assigned
- Dec 8, 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 | 0401008807 | VA | Primary |
Addresses
Primary practice location
306 South Shady Ave.
Damascus, VA 24236
Mailing address
306 South Shady Ave.
Damascus, VA 24236
Phone (276) 475-5116
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401008807 | VA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1639238264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "306 SOUTH SHADY AVE.",
"city": "DAMASCUS",
"state": "VA",
"postal_code": "24236",
"telephone_number": "276-475-5116",
"fax_number": "276-475-5665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "306 SOUTH SHADY AVE.",
"city": "DAMASCUS",
"state": "VA",
"postal_code": "24236",
"telephone_number": "276-475-5116",
"fax_number": "276-475-5665"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "PAUL",
"middle_name": "T",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401008807",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Damascus, VA
- Thomas Raymond Foltz Jr., D.C.
- H2 Rehabilitation Services of Virginia, LLC (H2 Health)
- K VA T Food Stores Inc (Food City Pharmacy)
- Laurel Family Drug Inc (Laurel Family Drug)
- Kimberly A McCall, PHARMD
- Shirley Kimberly Moretz, PMHNP
- St Charles Health Council Inc (Konnarock Family Health Center)
- St. Charles Health Council Inc (Holston Family Health Center)
- Trail Town Chiropractic PC
- Heather Triplett
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.