Individual provider Active NPI

Jennifer Ann Moore, D.M.D.

  • General Practice Dentistry
  • Levittown, NY
National Provider Identifier
1790825339
Registry record updated Oct 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
049808 Issued in NY
Practice address
3000 Hempstead Tpke
Suite 101
Levittown, NY 11756-1381
Phone
(516) 735-3535
NPI assigned
Feb 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 049808 NY Primary

Addresses

Primary practice location

3000 Hempstead Tpke
Suite 101
Levittown, NY 11756-1381

Mailing address

9 Beverly Rd
Bethpage, NY 11714-2201
Phone (516) 935-3083

Other names 1

  • Dr. Jennifer Ann Moore Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20160524000732 NY Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 6709175102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
049808NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Allan Dampf PC General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383004800000",
    "number": "1790825339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 BEVERLY RD",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117142201",
            "telephone_number": "516-935-3083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 HEMPSTEAD TPKE",
            "address_2": "SUITE 101",
            "city": "LEVITTOWN",
            "state": "NY",
            "postal_code": "117561381",
            "telephone_number": "516-735-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2013-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "049808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "MOORE",
            "middle_name": "ANN",
            "prefix": "DR.",
            "credential": "DMD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Levittown, NY

Sources for this page

Verify at the official NPI Registry.