Beverly Moon DMD LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

BEVERLY MOON DMD LLC

Practice address

4601 W 109TH St Ste 240
Overland Park, KS 66211-1323

Phone

(913) 338-3384

NPI assigned

Mar 4, 2020

Last updated

Mar 4, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Beverly Moon, DMDNPI 1154558831

Title

Dentist

Phone

(732) 754-1998

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Beverly Moon, DMD

  • General Practice Dentistry
  • Shawnee, KS
  • NPI 1154558831
  Authorized official Same address or phone

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

{
    "created_epoch": "1583280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583280000000",
    "number": "1962037523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16424 LUCILLE ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662217032",
            "telephone_number": "732-754-1998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 W 109TH ST STE 240",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111323",
            "telephone_number": "913-338-3384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEVERLY MOON DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-04",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A",
        "authorized_official_last_name": "MOON",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "732-754-1998",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Better Choice Homecare Services, LLC
• Stephanie Betterton
• Leah T Betzen, MS, T-LMFT
• Veronica Beuhler
• Shelia Bevan, LPC
• Kylee Beyea, SLP
• Aubrey Shea Beyer, MA, CCC-SLP
• Mary Katherine Beyer, C.R.N.A
• Beyond the Individual
• Bezanson Health LLC

• Dental Clinic/Center in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Dental Clinic/Center in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.