CHARON MOODY (NPI# 1558828160) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558828160 |
| Entity Type | Individual |
| Full Name | CHARON MOODY |
| Credential | RDHAP |
| Practice Address |
727 E Holborn Dr Carson CA 90746-2328 |
| Practice Telephone | 2135910807 |
| Mailing Telephone | 2135910807 |
| Enumeration Date | 2019-03-01 |
| Last Update Date | 2019-03-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 125K00000X | Advanced Practice Dental Therapist | 723 | CA | Dental Providers |
| Street Address |
727 E HOLBORN DR |
| City | CARSON |
| State | CA |
| Zip Code | 90746-2328 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174172837 | Darren Nakano Chiropractic, Professional Corporation | Chiropractor | 460 East Carson Plaza Drive, Suite 116, Carson, CA 90746 | 2019-09-05 |
| 1205370079 | Natalie Bland | Nurse Practitioner | 454 E. Carson Plaza Drive Suite 211, Carson, CA 90746 | 2016-12-13 |
| 1891146767 | Francis O Okpan | Nurse Practitioner | 17546 Buttonwood Ln, Carson, CA 90746 | 2016-06-22 |
| 1689049371 | Fresenius Medical Care Long Beach, LLC | Clinic/Center | 20710 Leapwood Ave Ste E, Carson, CA 90746 | 2015-12-07 |
| 1447649108 | Brandi Glenn | Occupational Therapist | 17811 Hazelwood Court, Carson, CA 90746 | 2015-01-20 |
| 1700226263 | Allen Berger | Counselor | 460 Est. Carson Plaza Dr. #119, Carson, CA 90746 | 2013-06-28 |
| 1902147036 | Basen Inc | Counselor | 460 Carson Plaza Drive, Ste 106, Carson, CA 90746 | 2013-03-14 |
| 1811238298 | Basen Inc | Counselor | 460 E Carsin Plaza Dr, #106, Carson, CA 90746 | 2013-03-08 |
| 1871858084 | Joseph H. Rodd M.d. Inc | Psychiatry & Neurology | 20710 S. Leapwood Ave., Suite B, Carson, CA 90746 | 2012-07-13 |
| 1467718601 | Laquesha Shonte Robinson | Counselor | 460 E. Carson Plaza Drive, Suite 200, Carson, CA 90746 | 2012-04-02 |
| Find all providers in zip 90746 | ||||
| Taxonomy Code | 125K00000X |
| Grouping | Dental Providers |
| Classification | Advanced Practice Dental Therapist |
| An Advanced Practice Dental Therapist is: (1) A dental therapist who has completed additional training beyond basic dental therapy education and provides dental services in accordance with state advanced practice dental therapist laws or statutes; or (2) A dental hygienist with a graduate degree in advanced dental therapy prepared for independent and interdependent decision making and direct accountability for clinical judgment across the dental health care continuum. The individual has been authorized by the relevant state board or a tribal entity to provide services under the remote supervision of a dentist. The functions of the advanced practice dental therapist vary based on the needs of the dentist, the educational preparation of the advanced practice dental therapist and state dental practice acts and regulations. |
| Notes: Source: Summarized from Minnesota Statute 150A.106. [7/1/2012: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538760459 | Carlos Heriberto Quinonez | Advanced Practice Dental Therapist | 16077 Chella Dr, Hacienda Heights, CA 91745-6402 | 2020-11-06 |
| 1033753298 | Lynnette Bradley | Advanced Practice Dental Therapist | 4218 Giles Ct, Riverside, CA 92503-3154 | 2019-10-31 |
| 1598314023 | Peter Korn | Advanced Practice Dental Therapist | 11135 Rosemary Dr, Auburn, CA 95603-5945 | 2019-09-06 |
| 1154982395 | Evelyn Marie Schrager | Advanced Practice Dental Therapist | 803 E Woodhaven Ln, Fresno, CA 93720-1209 | 2019-06-27 |
| 1104371368 | Marie Ekins Rdhap Corp | Advanced Practice Dental Therapist | 10831 Canelo Rd, Whittier, CA 90604-1902 | 2016-08-17 |
| 1922484682 | Travis Tramel | Advanced Practice Dental Therapist | 4199 Flat Rock Dr, Suite 127, Riverside, CA 92505-7115 | 2015-08-05 |
| 1851774186 | Terri De La Pena | Advanced Practice Dental Therapist | 10011 Shaggybark Dr, Santee, CA 92071-1136 | 2015-07-06 |
| 1720470230 | Christine Jackson-bartolomei | Advanced Practice Dental Therapist | 4806 Darlington Ln, Sacramento, CA 95835-2000 | 2015-02-21 |
| 1356753826 | Megan Ellen Graff | Advanced Practice Dental Therapist | 6084 Gold Spirit St, Eastvale, CA 92880-0988 | 2014-06-02 |
| 1275958597 | Theresa Zenner Clouse | Advanced Practice Dental Therapist | 1849 S Tamarack St, Visalia, CA 93277-8422 | 2014-02-24 |
| Find all providers with the same taxonomy | ||||
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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.