Victoria Nan Moore, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D6430 Issued in OR

Practice address

21352 SW Makah CT
Tualatin, OR 97062-9309

Phone

(503) 691-8376

NPI assigned

May 16, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811104300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21352 SW MAKAH CT.",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "97062",
            "telephone_number": "503-691-8376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21352 SW MAKAH CT",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970629309",
            "telephone_number": "503-691-8376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "VICTORIA",
        "middle_name": "NAN",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D6430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Miracle, LPC
• Debora Ann Mitchell, APRN, FNP-C
• Ayumi Mizuno, AGNP-C
• MK Ortho LLC
• Barbara K Moore, MD
• Mary E. Morrison, PA-C
• Daniel Moshofsky, PSYD
• Nima Motamedi, M.D.
• Erika Mote, FNP
• Roberta Mower, DC

• General Practice Dentistry in Tualatin, OR
• Providers in Tualatin, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.