Kent E. Moore, M.D., D.D.S.

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

5366 Issued in NC

Practice address

2711 Randolph Rd
Suite 510
Charlotte, NC 28207-2034

Phone

(704) 358-8898

Fax

(704) 358-8889

NPI assigned

Jul 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Nov 16, 2015 through Nov 16, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• DRS. Barts & Moore PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Charlotte, NC
  • NPI 1821008178
  NPD (past) Authorized official
• Providence Anesthesiology Associates, P.a.

  • Anesthesiology Physician
  • Charlotte, NC
  • NPI 1396739884
  NPD (past)

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563494400000",
    "number": "1851325260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 RANDOLPH RD",
            "address_2": "SUITE 510",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282072034",
            "telephone_number": "704-358-8898",
            "fax_number": "704-358-8889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 RANDOLPH RD",
            "address_2": "SUITE 510",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282072034",
            "telephone_number": "704-358-8898",
            "fax_number": "704-358-8889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KENT",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D., D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2019-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NC",
            "license": "5366",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NC",
            "license": "5366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamila Gabrianna Moore, LCSWA
• Jessica Moore, LPTA
• Joshua Aaron Moore, MD
• Julie Moore, LCMHC-A
• Kamaya Moore
• Kevin Scott Moore, PHARMD
• Kimberly Michelle Moore, MSW, LCSW
• Kristi L Moore, OT
• Kristi Michelle Moore, MD
• Kristin Delagrange Moore, AUD

• Oral & Maxillofacial Surgery (D.M.D.) in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2019; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.