Edward H Moody Jr DDS PC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DS4447 Issued in TN

Legal business name

EDWARD H MOODY JR DDS PC

Practice address

920 W Main St
Morristown, TN 37814-4515

Phone

(423) 587-1421

Fax

(423) 587-6092

NPI assigned

Jul 25, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Edward Herbert Moody Jr., DDSNPI 1396769006

Title

President

Phone

(423) 587-1421

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Edward Herbert Moody Jr., DDS

  • Pediatric Dentistry
  • Morristown, TN
  • NPI 1396769006
  NPD (past) Authorized official

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740202852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 W MAIN ST",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378144515",
            "telephone_number": "423-587-1421",
            "fax_number": "423-587-6092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 W MAIN ST",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378144515",
            "telephone_number": "423-587-1421",
            "fax_number": "423-587-6092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD H MOODY JR DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOODY",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "HERBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-587-1421",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TN",
            "license": "DS4447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Dentistry in Morristown, TN
• Providers in Morristown, TN by specialty
• Pediatric Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.