Jake Hyun Moon, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

34971 Issued in TX

Practice address

26795 US Highway 380 E Ste 400
Aubrey, TX 76227-7895

Phone

(972) 347-6200

NPI assigned

Sep 17, 2012

Sex

Male

Sole proprietor

No

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

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Dental Health Associates Pennsylvania PC

  • General Practice Dentistry
  • Phillipsburg, NJ
  • NPI 1477217560
  NPD (past)

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

{
    "created_epoch": "1347840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1669722658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26795 US HIGHWAY 380 E STE 400",
            "city": "AUBREY",
            "state": "TX",
            "postal_code": "762277895",
            "telephone_number": "972-347-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26795 US HIGHWAY 380 E STE 400",
            "city": "AUBREY",
            "state": "TX",
            "postal_code": "762277895",
            "telephone_number": "972-347-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "JAKE",
        "middle_name": "HYUN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-17",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "34971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Mitchell, DC
• Nisha Modi, DMD
• Brooke Modkins
• Lizete Montalvo
• Emily Eunjoo Moon, DDS
• Christopher Moore
• Meghan Morales, CNM
• Pamela S Moretti
• Bonique P Morton, MD, MPH
• Joshua A Morton I, MD, MBA

• General Practice Dentistry in Aubrey, TX
• Providers in Aubrey, 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 Feb 15, 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.

Verify at the official NPI Registry.