Moon Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MOON DENTAL LLC

Doing business as

Cornerstone Dental Health

Practice address

334 S 8TH St
Quincy, IL 62301-4106

Phone

(217) 222-4525

NPI assigned

Nov 7, 2022

Organization subpart

No

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

Authorized official

Name

Jenny Garcia-Rocha

Title

Credentialing Lead

Phone

(972) 869-3789

Specialties & licenses 1

Addresses

Other names 1

• Cornerstone Dental Health Doing business as

Locations

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

{
    "created_epoch": "1667779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667779200000",
    "number": "1760190003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "334 S 8TH ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623014106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 S 8TH ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623014106",
            "telephone_number": "217-222-4525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOON DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-07",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-06",
        "status": "A",
        "authorized_official_last_name": "GARCIA-ROCHA",
        "authorized_official_first_name": "JENNY",
        "authorized_official_title_or_position": "CREDENTIALING LEAD",
        "authorized_official_telephone_number": "972-869-3789"
    },
    "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": "Cornerstone Dental Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda A Molohon, CNP
• Sean James Monteyne, A.T.C.
• Laudoria B Montgomery
• Terry Montgomery, PTA
• Monty P Karoll, MD PC
• Kara C Moon, MSW, LSW
• Megan Elizabeth Moon, RD, LDN
• Briana Moore
• Brittney Moore, PHD
• Chase Moore, PHARMD

• General Practice Dentistry in Quincy, IL
• Providers in Quincy, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; 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.