NPIMap

Organization Active NPI

Sue K Moon DDS PC

  • General Practice Dentistry
  • Leesburg, VA
National Provider Identifier
1922345016
Registry record updated Jan 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401410385 Issued in VA
Legal business name
SUE K MOON DDS PC
Practice address
2 Cardinal Park Dr SE Ste 206a
Leesburg, VA 20175-4401
Phone
(703) 771-3389
Fax
(703) 771-8242
NPI assigned
Jan 9, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2013

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

Authorized official

Name
Dr. Sue K Moon, D.D.S.NPI 1164548806
Title
Doctor
Phone
(703) 771-3389

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 0401410385 VA Primary

Addresses

Primary practice location

2 Cardinal Park Dr SE Ste 206a
Leesburg, VA 20175-4401

Mailing address

2 Cardinal Park Dr SE Ste 206a
Leesburg, VA 20175-4401
Phone (703) 771-3389

Other names 1

  • Cornerstone Dental Doing business as

National Provider Directory

National Provider Directory

Locations

2 Cardinal Park Dr SE
Ste 206A
Leesburg, VA 20175
Phone (703) 771-1515

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": "1357689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357689600000",
    "number": "1922345016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CARDINAL PARK DR SE STE 206A",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201754401",
            "telephone_number": "703-771-3389",
            "fax_number": "703-771-8242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CARDINAL PARK DR SE STE 206A",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201754401",
            "telephone_number": "703-771-3389",
            "fax_number": "703-771-8242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUE K MOON DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-09",
        "last_updated": "2013-01-09",
        "status": "A",
        "authorized_official_last_name": "MOON",
        "authorized_official_first_name": "SUE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "703-771-3389",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401410385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cornerstone Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Leesburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2013; 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.