Individual provider Active NPI

Alexis Kendall Moore, D.M.D

  • Endodontics
  • Palmdale, CA
National Provider Identifier
1962757484
Registry record updated Jul 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
61559 Issued in CA
Practice address
41253 12TH St W Ste B
Palmdale, CA 93551-1413
Phone
(661) 266-2604
Fax
(661) 266-2119
NPI assigned
Jul 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 61559 CA Primary

Addresses

Primary practice location

41253 12TH St W Ste B
Palmdale, CA 93551-1413

Mailing address

812 Calle Dulcinea
San Clemente, CA 92672-2373
Phone (949) 370-3939

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1342742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343001600000",
    "number": "1962757484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 CALLE DULCINEA",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926722373",
            "telephone_number": "949-370-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41253 12TH ST W STE B",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935511413",
            "telephone_number": "661-266-2604",
            "fax_number": "661-266-2119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ALEXIS",
        "middle_name": "KENDALL",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-20",
        "last_updated": "2012-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "61559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2012; 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.