Chelese Rocenia Moore, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

062580 Issued in NY

Practice address

920 Lark Dr
Albany, NY 12207-1300

Phone

(518) 465-4771

NPI assigned

Apr 8, 2021

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

Enrolled in NC

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

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

{
    "created_epoch": "1617840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1881273597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 LARK DR",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122071300",
            "telephone_number": "518-465-4771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 LARK DR",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122071300",
            "telephone_number": "518-465-4771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CHELESE",
        "middle_name": "ROCENIA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-08",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "062580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sierra Dawn Moon, DO
• Ryan Mooney
• Abigail Moore
• Ashley Brook Moore, PA
• Britt E Moore, REGISTERED NURSE
• Crystal Dea Moore, PH.D., M.S.W., M.A.
• Danielle Moore
• Emily Alexandra Moore, RN
• Geneiva Michelle Moore
• Graig O'Neil Moore, RN

• Dentist in Albany, NY
• Providers in Albany, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2022; 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.