Michael Thomas Moody

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

0442000582 Issued in VA

Practice address

401 N 11TH St
Richmond, VA 23219-1901

Phone

(804) 828-0602

Fax

(804) 593-4279

NPI assigned

Apr 9, 2026

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1775692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1710829494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 980257",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232980257",
            "telephone_number": "804-828-9783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N 11TH ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232191901",
            "telephone_number": "804-828-0602",
            "fax_number": "804-593-4279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "MICHAEL",
        "middle_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-04-09",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "VA",
            "license": "0442000582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sierra Marie Montz, LCSW
• Monument Avenue Pediatrics
• Monument Medical Supplies LLC
• Monument Pathologists Inc
• Monument Radiology PC
• Tori Moody, BS, QMHP
• Christian Moon
• Hannah Moon, PA-C
• Joyce Haskins Moon, RN
• Lisa Moon, PH. D

• Oral & Maxillofacial Surgery (D.M.D.) in Richmond, VA
• Providers in Richmond, VA by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2026; 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.