Andrew G Moore, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

36829 Issued in TX

Practice address

107 Yale St
Houston, TX 77007-3753

Phone

(832) 709-2418

NPI assigned

May 20, 2020

Last updated

Oct 27, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mgmdds

  • Dentist
  • Webster, TX
  • NPI 1093948044
  NPD (past)

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

{
    "created_epoch": "1589932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1922621309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 YALE ST STE 300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770073754",
            "telephone_number": "832-709-2418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 YALE ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770073753",
            "telephone_number": "832-709-2418"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13810 John Audubon Pkwy Ste A",
            "address_purpose": "LOCATION",
            "city": "Webster",
            "state": "TX",
            "postal_code": "775983864",
            "country_code": "US",
            "telephone_number": "281-486-9222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ANDREW",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-20",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "36829",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "36829",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TN",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Moore, MS CCC SLP
• Adam Moore, M.D.
• Alaina Elizabeth Moore, M.D.
• Alexis Moore
• Alicia Carlette Moore, NCC, LPC, CI
• Angela Lynn Moore, LMSW
• Antonia Moore, LCSW
• April Laquinta Moore, APRN
• Ashley Moore, CART
• Ashley Moore

• Dentist in Houston, TX
• Providers in Houston, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; 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.