Melvin Gregory Moore, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7175 Issued in TN

Practice address

4723 N Roan St
Johnson City, TN 37615-3886

Phone

(423) 283-0511

Fax

(423) 283-0899

NPI assigned

Nov 13, 2006

Sex

Male

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

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.

• Greg Moore, DDS

  • Dental Clinic/Center
  • Johnson City, TN
  • NPI 1154249340
  NPD (past) Authorized official

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1891866893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4723 N ROAN ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376153976",
            "telephone_number": "423-283-0511",
            "fax_number": "423-283-0899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4723 N ROAN ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376153886",
            "telephone_number": "423-283-0511",
            "fax_number": "423-283-0899"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3130 Lee Hwy Ste 110",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "VA",
            "postal_code": "242026026",
            "country_code": "US",
            "telephone_number": "276-669-1370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MELVIN",
        "middle_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401419946",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "7175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corrinne Elizabeth Moore
• Jerica Moore, MA, ATC
• Jessica Moore, RN
• Jessica Rivers Moore
• Jordan Elizabeth Moore
• Sean Anthony Moore, MD
• Stephanie Moore, DNP, APRN, WHNP-BC
• Moorehouse Group
• Moorehouse Group, Inc
• Vicki Blake Moorehouse, LPC-MHSP, SAP, LMHC

• General Practice Dentistry in Johnson City, TN
• Providers in Johnson City, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2026; 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.