Ketron V. Moss, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

010857 Issued in GA

Practice address

620 Main St
Young Harris, GA 30582-4118

Phone

(706) 379-6677

Fax

(706) 379-1968

NPI assigned

Dec 7, 2005

Last updated

Jul 13, 2026By the provider in NPPES

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

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1760467310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 MAIN ST",
            "city": "YOUNG HARRIS",
            "state": "GA",
            "postal_code": "305824118",
            "telephone_number": "706-379-6677",
            "fax_number": "706-379-1968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 MAIN ST",
            "city": "YOUNG HARRIS",
            "state": "GA",
            "postal_code": "305824118",
            "telephone_number": "706-379-6677",
            "fax_number": "706-379-1968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "KETRON",
        "middle_name": "V.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "010857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lance David Markham, ATC, CSCS
• Mary Emma B Jones PHD PC
• Theresa Marie Mayhew, MA
• Kayla Leigh Moody, PTA
• Abby Morgan
• Major Moss
• Jimmie Jo Nichols
• Npcwoods Telemedicine, PLLC
• Pro Medical Transport LLC (Pro Medical Transport)
• Patrick Rushing, DC

• General Practice Dentistry in Young Harris, GA
• Providers in Young Harris, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.