DR. BRENDEN DELANEY MOON DMD NPI 1730375171

NPI Information

  • NPI: 1730375171
  • Provider Name: DR. BRENDEN DELANEY MOON, DMD
  • Classification: Dentist - 122300000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 671 WABASH AVE
    CARTHAGE, IL
    ZIP 62321
  • Phone: (217) 357-2171

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NPI Details

DR. Brenden Delaney Moon, DMD is a dentist in Carthage, IL. The provider is a dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. DR. Brenden Delaney Moon, DMD NPI is 1730375171. 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:

671 WABASH AVE
CARTHAGE, IL
ZIP 62321
Phone: (217) 357-2171
Fax: (217) 357-3562

The NPI 1730375171 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 9/19/2007 and was last updated on 9/7/2011.

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
1122300000XDentist019027433ILLINOISYes

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
19202327MEDICAIDILLINOIS

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: 3/30/2025

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