Barbara Allison Moore, DMD
Individual provider Active NPI Dentist · Tega Cay, SC
NPI 1902472012 · NPPES record last updated Jun 16, 2022
Key facts
- NPI
- 1902472012
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 9961 (SC)
- Practice address
- 1147 Stonecrest Blvd Ste 105
Tega Cay, SC 29708-6606 - Phone
- (803) 547-6000
- NPI assigned
- May 29, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Wylie Modern Dentistry, PC | Dentist | Current |
Accepting new patients |
| Cabana Dental Associates Inc. | Current |
Accepting new patients |
Locations
140 Highway 274
Lake Wylie, SC 29710
Phone (803) 752-0565
1147 Stonecrest Blvd
Ste 105
Tega Cay, SC 29708
Phone (803) 547-6000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 9961 | SC | Yes |
Addresses
Primary practice location
1147 Stonecrest Blvd Ste 105
Tega Cay, SC 29708-6606
Mailing address
1562 Mill Spring Dr Apt G04
Fort Mill, SC 29715-4544
Phone (803) 235-2182
Other practice location 1
140 Highway 274
Clover, SC 29710-6045
Phone (803) 752-0565
Other providers in Tega Cay, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 16, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.