Active NPI
Kristin Nicole Moore, DMD, MS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Lake Zurich, IL
National Provider Identifier
1639503519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 021002474
- Practice address
- 900 W Il Route 22
Suite 170
Lake Zurich, IL 60047-3416 - Phone
- (847) 438-9090
- NPI assigned
- Aug 27, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019028048 | IL | |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 021002474 | IL | Primary |
Addresses
Primary practice location
900 W Il Route 22
Suite 170
Lake Zurich, IL 60047-3416
Mailing address
900 W Il Route 22
Suite 170
Lake Zurich, IL 60047-3416
Phone (847) 438-9090
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019028048 | IL | MD | Dentist |
| 021002474 | IL | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kristin N. Moore, D.M.D., M.S., P.C. | Orthodontics and Dentofacial Orthopedics | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- Lake Zurich, IL
- NPI 1184013575
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662940800000",
"number": "1639503519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 W IL ROUTE 22",
"address_2": "SUITE 170",
"city": "LAKE ZURICH",
"state": "IL",
"postal_code": "600473416",
"telephone_number": "847-438-9090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 W IL ROUTE 22",
"address_2": "SUITE 170",
"city": "LAKE ZURICH",
"state": "IL",
"postal_code": "600473416",
"telephone_number": "847-438-9090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "KRISTIN",
"middle_name": "NICOLE",
"name_prefix": "Dr.",
"credential": "DMD, MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-27",
"last_updated": "2022-09-12",
"certification_date": "2022-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019028048",
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "IL",
"license": "021002474",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Zurich, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.