Justin David Moody, DDS, P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

JUSTIN DAVID MOODY, DDS, P.C.

Doing business as

Affordable Dentures & Implants - Yakima

Practice address

102 N Fair Ave Ste 102
Yakima, WA 98901-4543

Phone

(509) 469-0875

NPI assigned

Aug 28, 2024

Organization subpart

No

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

Authorized official

Name

Justin Moody, DDS

Title

Owner

Phone

(509) 469-0875

Specialties & licenses 1

Addresses

Other names 1

• Affordable Dentures & Implants - Yakima Doing business as

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

{
    "created_epoch": "1724803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724803200000",
    "number": "1699509018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 N FAIR AVE STE 102",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989014543",
            "telephone_number": "509-469-0875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 N FAIR AVE STE 102",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989014543",
            "telephone_number": "509-469-0875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUSTIN DAVID MOODY, DDS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-28",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A",
        "authorized_official_last_name": "MOODY",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-469-0875",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Affordable Dentures & Implants - Yakima",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carol Jurs
• Alicia Ann Justice
• Cameron Bradley Justice, D.O.
• Katherine Ellen Justice, DO
• Wade W Justice, M.D.
• Gretchen A Kaizer, PA, RN
• Dianna M Kallis, ARNP
• Tara Whitney Kamprath, PHARM.D.
• Shefali Kanal
• Michael D Kane, MPT MOMT

• General Practice Dentistry in Yakima, WA
• Providers in Yakima, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; 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.