George Terrance Moody, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2090-84 Issued in MS

Practice address

1450 Oak St
Grenada, MS 38901-4600

Phone

(662) 226-0554

Fax

(662) 226-0556

NPI assigned

Mar 6, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1992835151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1004",
            "city": "GRENADA",
            "state": "MS",
            "postal_code": "389021004",
            "telephone_number": "662-226-0554",
            "fax_number": "662-226-0556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 OAK ST",
            "city": "GRENADA",
            "state": "MS",
            "postal_code": "389014600",
            "telephone_number": "662-226-0554",
            "fax_number": "662-226-0556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "GEORGE",
        "middle_name": "TERRANCE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "2090-84",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00060069",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph S Messina Jr., MD
• Mississippi CVS Pharmacy, L.L.C.
• Mississippi Inpatient Medicine Associates, PLLC
• Mississippi Medical Products
• Mississippi State Department of Health
• Candice Moore, OTR/L
• Gale Moore, C.N.M.
• James R Moore Jr., R. PH.
• Kayla Anglin Moore, NP-C
• Morris Family Chiropractic PA

• General Practice Dentistry in Grenada, MS
• Providers in Grenada, MS by specialty
• General Practice Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.