Gregory Carl Moo, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DN9681 Issued in FL

Practice address

1601 Timber Hills Dr
Deland, FL 32724-7978

Phone

(386) 334-4074

Fax

(386) 736-0111

NPI assigned

May 25, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689885121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 TIMBER HILLS DR",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327247978",
            "telephone_number": "386-334-4074",
            "fax_number": "386-736-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 TIMBER HILLS DR",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327247978",
            "telephone_number": "386-334-4074",
            "fax_number": "386-736-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOO",
        "first_name": "GREGORY",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN9681",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12007496",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mohan L Sharma MD PA
• Jolie Alyssa Dickey Molina Maldonado, MS, RMHCI
• Lynn Mondelus
• Thomas Jude Montaldo, M.D.
• Francisca Montero, DDS
• Sherri A Moore, RPH
• Vikki Lynn Moore, D.C.
• Erin Morcom, PTA
• April D Morris, ARNP
• Shaneka Dalon Morris

• Dentist in Deland, FL
• Providers in Deland, FL by specialty
• Dentist in Florida

• 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.

Verify at the official NPI Registry.