DR. REGAN L MOORE DDS NPI 1093853095

NPI Information

NPI: 1093853095
Provider Name: DR. REGAN L MOORE, DDS
Classification: Dentist - 1223P0300X
Entity Type: Individual

Specialization: Periodontics

Address:
501 S PRESTON ST
LOUISVILLE, KY
ZIP 40292
Phone: (502) 852-5128
Get Directions

DR. Regan L Moore, DDS is a periodontics dentist in Louisville, KY. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. DR. Regan L Moore, DDS NPI is 1093853095. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

501 S PRESTON ST
LOUISVILLE, KY
ZIP 40292-001
Phone: (502) 852-5128
Fax: (502) 852-7163

The enumeration date for this NPI number is 2/2/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223P0300X	Dentist	Periodontics	5947	KENTUCKY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	9179124	OTHER		DORAL DENTAL
2	6003670	MEDICAID	KENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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