NPIMap

Organization Active NPI

Jimmy Joe Moon, DDS & Barbara Seid Moon, DDS, Inc.

  • Dental Clinic/Center
  • Pasadena, TX
National Provider Identifier
1902011307
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
13206 Issued in TX
Legal business name
JIMMY JOE MOON, DDS & BARBARA SEID MOON, DDS, INC.
Practice address
2009 John St
Pasadena, TX 77502-3375
Phone
(713) 473-6677
Fax
(713) 473-6778
NPI assigned
May 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jimmy Joe Moon, D.D.S.NPI 1629077839
Title
President
Phone
(713) 473-6677

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 13002 TX
Dental Clinic/Center 261QD0000X 13206 TX Primary

Addresses

Primary practice location

2009 John St
Pasadena, TX 77502-3375

Mailing address

2009 John St
Pasadena, TX 77502-3375
Phone (713) 473-6677

National Provider Directory

National Provider Directory

Locations

2009 John St
Pasadena, TX 77502
Phone (713) 473-6677

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902011307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2009 JOHN ST",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775023375",
            "telephone_number": "713-473-6677",
            "fax_number": "713-473-6778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2009 JOHN ST",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775023375",
            "telephone_number": "713-473-6677",
            "fax_number": "713-473-6778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JIMMY JOE MOON, DDS & BARBARA SEID MOON, DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOON",
        "authorized_official_first_name": "JIMMY",
        "authorized_official_middle_name": "JOE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "713-473-6677",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "TX",
            "license": "13002",
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "TX",
            "license": "13206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.