BEVERLY MOON (NPI# 1154558831) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154558831 |
| Entity Type | Individual |
| Full Name | BEVERLY MOON |
| Other Name | BEVERLY MOULIC |
| Credential | DMD |
| Practice Address |
5550 Hedge Lane Ter Shawnee KS 66226-2253 |
| Mailing Address |
1608 S Garfield St Junction City KS 66441-3966 |
| Practice Telephone | 9134226699 |
| Mailing Telephone | 7327541998 |
| Enumeration Date | 2009-06-19 |
| Last Update Date | 2013-02-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
60824 | KS | Dental Providers |
| Street Address |
5550 HEDGE LANE TER |
| City | SHAWNEE |
| State | KS |
| Zip Code | 66226-2253 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184834145 | Andrew Stewart Moore | Dentist | 5550 Hedge Lane Ter, Shawnee, KS 66226-2253 | 2007-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124598792 | Kaitlyn Nicole Jackman | Specialist/Technologist | 6320 Anderson St, Shawnee, KS 66226 | 2018-11-27 |
| 1912436379 | Alexandra Snyder | Behavioral Analyst | 23714 W. 54th Terr., Shawnee, KS 66226 | 2017-06-08 |
| 1992179741 | Melanie Miller | Nurse Practitioner | 5211 Woodsonia Dr, Shawnee, KS 66226 | 2015-11-17 |
| 1639512395 | Marjon Monfared | Family Medicine | 6815 Hilltop Rd Ste 100, Shawnee, KS 66226 | 2013-04-12 |
| 1063726941 | Kinsey Rachel Honeyman | Optometrist | 5433 Roberts Street, Shawnee, KS 66226 | 2010-08-03 |
| 1093974529 | Kansas Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 22700 W 55th Terrace, Shawnee, KS 66226 | 2008-06-09 |
| 1194811620 | William Schmidt | Physician Assistant | 6850 Hilltop Road, Suite 170, Shawnee, KS 66226 | 2006-10-04 |
| 1205280450 | Emily Meyer | Dentist | 6810 Silverheel St, Shawnee, KS 66226 | 2016-04-13 |
| 1013352384 | Honeyman Investments LLC | Eyewear Supplier (Equipment, not the service) | 5433 Roberts Street, Shawnee, KS 66226 | 2013-05-01 |
| 1457429524 | Steven D Rettinger | Family Medicine | 6815 Hilltop Rd, Ste 100, Shawnee, KS 66226 | 2006-11-30 |
| Find all providers in zip 66226 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326656117 | Joel David Piper | Dentist | 10840 Shawnee Mission Pkwy, Shawnee, KS 66203-3512 | 2020-07-17 |
| 1518450642 | Matthew Nicholas Scott | Dentist | 6852 Silverheel St, Shawnee, KS 66226-5300 | 2018-06-13 |
| 1710498050 | Reggie Cooley | Dentist | 4520 Market Place Blvd, Shawnee, OK 74804-0804 | 2017-10-13 |
| 1144494147 | Impressions Dental | Dentist | 2510 E Independence St Ste 600, Shawnee, OK 74804-1839 | 2008-04-22 |
| 1184834145 | Andrew Stewart Moore | Dentist | 5550 Hedge Lane Ter, Shawnee, KS 66226-2253 | 2007-05-22 |
| 1205959582 | Charles B Swain | Dentist | 5638 Nieman Rd, Shawnee, KS 66203-2348 | 2007-04-09 |
| 1912026162 | Amy Laymon | Dentist | 4520 Market Place Blvd Ste A, Shawnee, OK 74804-0805 | 2007-03-28 |
| 1295854958 | Jack C Luman | Dentist | 1410 N Harrison St, Shawnee, OK 74801 | 2007-03-27 |
| 1659412237 | Carol J. Akers | Dentist | 12480 W 62nd Ter Ste 200, Shawnee, KS 66216 | 2007-02-08 |
| 1720128002 | Ocean Dental, PC | Dentist | 4409 N Kickapoo Ave, Shawnee, OK 74804-1206 | 2007-02-07 |
| Find all providers in SHAWNEE | ||||
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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.