DR. JERRY WAYNE MOODY (NPI# 1578780979) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578780979 |
| Entity Type | Individual |
| Full Name | DR. JERRY WAYNE MOODY |
| Credential | D.D.S. |
| Practice Address |
501 Tyee Dr Sw Tumwater WA 98512-7313 |
| Practice Telephone | 3603525100 |
| Practice Fax Number | 3607051274 |
| Mailing Telephone | 3603525100 |
| Mailing Fax Number | 3607051274 |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DE00006219 | WA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902033087 | Jerry Ray Moody | Dietitian, Registered | 12647 Olive Blvd Ste 600, Saint Louis, MO 63141-6346 | 2009-06-16 |
| Street Address |
501 TYEE DR SW |
| City | TUMWATER |
| State | WA |
| Zip Code | 98512-7313 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245893601 | Joshua Merrell, Dds, Pllc | Clinic/Center | 501 Tyee Dr Sw, Tumwater, WA 98512-7313 | 2019-04-20 |
| 1043316334 | Joseph Thomas Bradley | Dentist | 501 Tyee Dr Sw, Tumwater, WA 98512-7313 | 2006-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578161402 | Yavonnie Leslie Griggs | Peer Specialist | 3285 Ferguson Ln Sw, Tumwater, Wa 98512, Tumwater, WA 98512 | 2020-10-13 |
| 1205465622 | Falina Marie Luce | Counselor | 3285 Ferguson St, Olympia, WA 98512 | 2020-04-07 |
| 1881234912 | Andres Enrique Velazquez | Counselor | 3285 Ferguson St Sw Wa 98512, Tumwater, WA 98512 | 2020-01-07 |
| 1700432507 | Maria E Zavala Negrete | Behavior Technician | 3285 Ferguson Street Southwest, Tumwater, WA 98512 | 2019-08-16 |
| 1669026951 | Bradley Allen Labrador | Social Worker | 3285 Ferguson St, Sw, Tumwater, WA 98512 | 2019-07-25 |
| 1033762893 | Janice Lapreal Swanzey | Licensed Practical Nurse | 3285 Ferguson Lane St Sw, Olympia, WA 98512 | 2019-07-22 |
| 1821569195 | Linda Marie Moffitt | Registered Nurse | 7741 Littlerock Rd. Sw, Tumwater, WA 98512 | 2018-12-16 |
| 1427534577 | Matthew Hart | Occupational Therapist | 2620 Rw Johnson Boulevard Southwest Suite 112, Tumwater, WA 98512 | 2018-07-12 |
| 1558858019 | Amy Louise Cline | Counselor | 6005 Tyee Drive Sw, Tumwater, WA 98512 | 2018-04-19 |
| 1669998183 | Bradley Ross Bishop | Registered Nurse | 3285 Ferguson Street Sw, Tumwater, WA 98512 | 2017-08-16 |
| Find all providers in zip 98512 | ||||
| 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 |
|---|---|---|---|---|
| 1336797273 | Sea-mar Community Health Center | Dentist | 6004 Capitol Ave Sw, Tumwater, WA 98501 | 2019-09-03 |
| 1295233344 | Richard C Downing Dds Pllc | Dentist | 6939 Littlerock Rd Sw Ste B, Tumwater, WA 98512-7246 | 2018-01-24 |
| 1285826537 | Steven L. Paige | Dentist | 6015 Capitol Blvd, Tumwater, WA 98045 | 2007-08-10 |
| 1083790588 | Yongqian Huang | Dentist | 409 Custer Way Se, Suite C, Tumwater, WA 98501-3350 | 2006-10-27 |
| 1255413845 | Arne Erik Gundersen | Dentist | 115 Cleveland Ave Se, Tumwater, WA 98501-7718 | 2006-10-20 |
| 1548273782 | Adam Philip Cramer | Dentist | 1502 Bishop Rd Sw, Tumwater, WA 98512-7354 | 2006-08-15 |
| 1851374862 | John Junji Shingu | Dentist | 3926 Cleveland Ave Se, Tumwater, WA 98501-4023 | 2005-11-22 |
| 1447877857 | Dental Professionals of Washington Quirt Mongrain Gibree PC | Dentist | 6939 Littlerock Rd Sw Ste B, Tumwater, WA 98512-7246 | 2020-07-01 |
| 1669025417 | Mccauslin Thomas Rainwater | Dentist | 1502 Bishop Rd Sw, Tumwater, WA 98512-7354 | 2019-07-22 |
| 1134642713 | Ajaipal Dhanoa | Dentist | 6015 Capitol Blvd Sw, Tumwater, WA 98501-5268 | 2017-07-25 |
| Find all providers in TUMWATER | ||||
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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.