John F. Moore, D.D.S.,M.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Practice address

18130 Halsted St
Homewood, IL 60430-2507

Phone

(708) 799-2550

Fax

(708) 799-1094

NPI assigned

Sep 27, 2007

Last updated

Sep 27, 2007By 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 IL

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

Credentials

Master of Science

State licenses

Practice roles

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

• Endodontic & Periodontic Associates, LTD

  • Endodontics
  • Homewood, IL
  • NPI 1013075480

  Periodontics

  NPD (past)

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

{
    "created_epoch": "1190851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190851200000",
    "number": "1801083423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18130 HALSTED ST",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302507",
            "telephone_number": "708-799-2550",
            "fax_number": "708-799-1094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18130 HALSTED ST",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302507",
            "telephone_number": "708-799-2550",
            "fax_number": "708-799-1094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JOHN",
        "middle_name": "F.",
        "credential": "D.D.S.,M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-27",
        "last_updated": "2007-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Miroballi, NP
• Mission Optical, Inc.
• Juanikee Mitchell, OT
• Mixed Inclusion
• Oluwadamilola Oluseyi Monehin
• Keeley Rae Moore, M.A. CCC-A
• Tina Moore
• Alyanna Mae Moraga
• Daisy Moraga
• Deborah Moraga, LMT

• Periodontics in Homewood, IL
• Providers in Homewood, IL by specialty
• Periodontics in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2007; 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.