Individual provider Active NPI

David B Moore, DDS

  • Dentist
  • Connersville, IN
National Provider Identifier
1861400830
Registry record updated Jan 17, 2013
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Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12010307A Issued in IN
Practice address
210 W 7TH St
Connersville, IN 47331
Phone
(765) 825-5155
Fax
(765) 827-6291
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12010307A IN Primary

Addresses

Primary practice location

210 W 7TH St
Connersville, IN 47331

Mailing address

210 W 7TH St
Connersville, IN 47331
Phone (765) 825-5155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20130123000254 IN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3476706508

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358380800000",
    "number": "1861400830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W 7TH ST",
            "city": "CONNERSVILLE",
            "state": "IN",
            "postal_code": "47331",
            "telephone_number": "765-825-5155",
            "fax_number": "765-827-6291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W 7TH ST",
            "city": "CONNERSVILLE",
            "state": "IN",
            "postal_code": "47331",
            "telephone_number": "765-825-5155",
            "fax_number": "765-827-6291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "DAVID",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2013-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12010307A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Connersville, IN

Sources for this page

Verify at the official NPI Registry.