Moody Dental Implant Centers LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

M881 Issued in SD

Legal business name

MOODY DENTAL IMPLANT CENTERS LLC

Practice address

705 Columbus St
Rapid City, SD 57701-3623

Phone

(605) 716-5622

Fax

(605) 791-2982

NPI assigned

Nov 1, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Justin D Moody, DDS

Title

Owner

Phone

(605) 716-5622

Specialties & licenses 1

Addresses

Other names 1

• The Dental Implant Center Other name

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

{
    "created_epoch": "1320105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474502400000",
    "number": "1649556978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 COLUMBUS ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577013623",
            "telephone_number": "605-716-5622",
            "fax_number": "605-791-2982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 COLUMBUS ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577013623",
            "telephone_number": "605-716-5622",
            "fax_number": "605-791-2982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOODY DENTAL IMPLANT CENTERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-01",
        "last_updated": "2016-09-22",
        "status": "A",
        "authorized_official_last_name": "MOODY",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "605-716-5622",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "SD",
            "license": "M881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Dental Implant Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Monument Health Rapid City Hospital, Inc. (Monument Health Dermatology and Plastic Surgery)
• Monument Health Rapid City Hospital, Inc.
• Monument Health Rapid City Hospital, Inc. (Monument Health Rehabilitation Center)
• Monument Health Rapid City Hospital, Inc. (Monument Health General Surgery)
• Monument Health Rapid City Hospital. Inc. (Monument Health Rapid City Clinic, 5th Street)
• Lisa R Moon, RN
• Nichole Mooney, FNP-BC
• Tiffany Mooney, LPC-MH, QMHP
• Jodi Lynn Moore, RN
• Melissa H Moore, PTA

• General Practice Dentistry in Rapid City, SD
• Providers in Rapid City, SD by specialty
• General Practice Dentistry in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2016; 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.