Heritage Moore - Ams, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

HERITAGE MOORE - AMS, PLLC

Doing business as

Heritage Dental

Practice address

121 Park Hill Dr Ste a
Fredericksburg, VA 22401-3357

Phone

(540) 373-1660

NPI assigned

Dec 5, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Clarissa M Moore, DDSNPI 1578726279

Title

Practice Owner

Phone

(540) 373-1660

Specialties & licenses 1

Addresses

Other names 1

• Heritage Dental Doing business as

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Clarissa M Moore, DDS

  • Dentist
  • Gainesville, VA
  • NPI 1578726279
  NPD Authorized official
• Edith Socorro Gonzalez Jaimes, D.D.S.

  • Dentist
  • Fredericksburg, VA
  • NPI 1013405992
  NPD
• Daniah Tikreeti, BDS

  • Dentist
  • Fredericksburg, VA
  • NPI 1366163586
  NPD

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

{
    "created_epoch": "1733356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733356800000",
    "number": "1720894629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 PARK HILL DR STE A",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013357",
            "telephone_number": "540-373-1660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 PARK HILL DR STE A",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013357",
            "telephone_number": "540-373-1660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE MOORE - AMS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-05",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "CLARISSA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRACTICE OWNER",
        "authorized_official_telephone_number": "540-373-1660",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David Scott Heppe, D.C.
• Erica Grace Heppe, D.C.
• Howard P Heppe, M.D.
• Amanda Herbert
• Carlos Alan Heresi, D.D.S
• Rachel Herman
• Evette M Hernandez, N.P., C.N.M.
• Rafael O. Hernandez, M.D.
• Rebekah Leah Herrin, OTRL
• Marie Annette Hertle, SLPA

• Dental Clinic/Center in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Dental Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.