Wendy Miranda Moore, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401008888 Issued in VA

Practice address

9449 Grover Dr
King George, VA 22485-7076

Phone

(540) 775-5774

Fax

(540) 775-6538

NPI assigned

Apr 26, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

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

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

Previously, effective Oct 1, 2014 through Oct 1, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851511356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9449 GROVER DR",
            "city": "KING GEORGE",
            "state": "VA",
            "postal_code": "224857076",
            "telephone_number": "540-775-5774",
            "fax_number": "540-775-6538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9449 GROVER DR",
            "city": "KING GEORGE",
            "state": "VA",
            "postal_code": "224857076",
            "telephone_number": "540-775-5774",
            "fax_number": "540-775-6538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "WENDY",
        "middle_name": "MIRANDA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401008888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kari McLaughlin
• Tiffany Joanne Meeks, LPC
• Bryson Jesus Malverde Mellon - Valenzuela
• Shannon D Mones, FNP
• Leah M Moore
• Chloe Fulcher Morrissett, LPC
• MWHC Urgent Care LLC (Mary Washington Urgent Care)
• Nakhi Care Transportation LLC
• Sydney Naylor
• Daniel K Nelson

• General Practice Dentistry in King George, VA
• Providers in King George, VA by specialty
• General Practice Dentistry in Virginia

• 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.
• 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.