DR. CAROLYN S MOODY (NPI# 1093799819) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1093799819 |
Entity Type | Individual |
Full Name | DR. CAROLYN S MOODY |
Credential | DMD |
Practice Address |
303 S 4th St Suite 200 Danville KY 40422-2004 |
Practice Telephone | 8592368448 |
Practice Fax Number | 8592398909 |
Mailing Telephone | 8592368448 |
Mailing Fax Number | 8592398909 |
Enumeration Date | 2005-12-05 |
Last Update Date | 2014-01-09 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 122300000X | Dentist | 5693 | KY | Dental Providers |
Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
5693 | KY | Dental Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
KY | 60056934 | 05 | |
KY | 45601101 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356432439 | Carolyn A Moody | Specialist | 151 Southwest Dr, Jonesboro, AR 72401-5828 | 2006-09-27 |
Street Address |
303 S 4TH ST SUITE 200 |
City | DANVILLE |
State | KY |
Zip Code | 40422-2004 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679170104 | Caroline Pellegrino | Nurse Practitioner | 303 S 4th St, Danville, KY 40422-2091 | 2020-10-07 |
1083059711 | Miranda Lou Munday | Pediatrics | 303 S 4th St, Danville, KY 40422-2091 | 2013-05-08 |
1326341314 | Jason E Tewmey | Physician Assistant | 303 S 4th St, Danville, KY 40422-2091 | 2010-12-13 |
1003060260 | Joshua Scott Wiglesworth | Pediatrics | 303 S 4th St, Danville, KY 40422-2091 | 2008-11-13 |
1427238898 | Shelley Renee Gover | Nurse Practitioner | 303 S 4th St, Danville, KY 40422-2091 | 2007-11-14 |
1417141326 | Rachel Cooper Briese | Nurse Practitioner | 303 S 4th St, Danville, KY 40422-2091 | 2007-09-04 |
1487854584 | Janet Fluty | Dietitian, Registered | 303 S 4th St, Danville, KY 40422-2004 | 2007-07-18 |
1831399955 | Sheila Michelle Sisk | Nurse Practitioner | 303 S 4th St, Danville, KY 40422-2004 | 2007-07-18 |
1265547723 | Danville Pediatrics and Primary Care, Pllc | Pediatrics | 303 S 4th St, Danville, KY 40422-2004 | 2006-08-21 |
1730129586 | Danville Pediatrics, Psc | Pediatrics | 303 S 4th St, Danville, KY 40422-2004 | 2006-06-08 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568098754 | Healthstat Onsite Clinic Centre College | Preventive Medicine | 851 West Walnut St, Danville, KY 40422 | 2020-03-19 |
1134772288 | Austin Simpson | Physician Assistant | 217 South 3rd Street, Danville, KY 40422 | 2019-07-18 |
1033677695 | Shannon Holland Erwin | Counselor | 475 W Main St Suite 160, Danville, KY 40422 | 2019-03-03 |
1225556871 | Fallon Michelle Carnes | Counselor | 106 Belinda Blvd., Danville, KY 40422 | 2017-09-05 |
1780124529 | Natasha Taylor | Counselor | 461 South 4th Street, Danville, KY 40422 | 2017-02-27 |
1184088890 | Elizabeth Love | Counselor | 108 Saint Josephs Ct, Danville, KY 40422 | 2016-04-08 |
1801274550 | Jeremy Tate Johnson | Specialist/Technologist | 1637 Perryville Rd., Boyle County High School, Danville, KY 40422 | 2015-05-14 |
1649602228 | Susan Hale Couzens | Dentist | 435 Whirlaway Dr, Danville, KY 40422 | 2013-08-06 |
1265751200 | William Paul Baas | Ophthalmology | 440 W. Martin L. King Blvd., Suite 100, Danville, KY 40422 | 2010-05-28 |
1780823666 | Karen Totsuka IIi | Speech-Language Pathologist | 642 Nth 3rd St, Danville, KY 40422 | 2009-02-17 |
Find all providers in zip 40422 |
Taxonomy Code | 1223P0221X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Pediatric Dentistry |
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831606094 | Djr2 Professional Limited Liability Company | Dentist | 303 S 4th St Ste 201, Danville, KY 40422-2091 | 2018-01-09 |
1962927962 | Joshua R. Twiss, D.d.s., Inc. | Dentist | 822 Hartz Way Ste 100, Danville, CA 94526-3433 | 2017-08-10 |
1760772230 | Danville Pediatric Dentistry, Psc | Dentist | 1080 Ben Ali Dr, Suite A, Danville, KY 40422-8937 | 2011-04-18 |
1871728279 | Dana Libby Kapp | Dentist | 4135 Blackhawk Plaza Cir Ste 260, Danville, CA 94506 | 2009-05-28 |
1457565624 | Azadeh Jafarnia | Dentist | 301 Sycamore Valley Rd W, Danville, CA 94526-3949 | 2007-05-09 |
1376661785 | Amit Goyal | Dentist | 136 Coolspring Ct, Danville, CA 94506-1204 | 2007-03-26 |
1578571378 | Donald C. Schmitt, Dds & Rinku S. Saini, Dds, Inc. | Dentist | 300 El Cerro Blvd, Ste E, Danville, CA 94526 | 2006-08-04 |
1144541095 | Jessica Jinhee Lee | Dentist | 100 N Academy Ave, Danville, PA 17822 | 2010-06-15 |
1932425691 | Gayatri Malik | Dentist | 100 North Academy Ave., Danville, PA 17822-1336 | 2010-04-20 |
1376796714 | Karen A. Uston | Dentist | 100 N Academy Ave, Danville, PA 17822-1336 | 2008-10-29 |
Find all providers in DANVILLE |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.