DR. RICHARD T MOON (NPI# 1639220833) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639220833 |
| Entity Type | Individual |
| Full Name | DR. RICHARD T MOON |
| Credential | DDS |
| Practice Address |
6712 N Mountello Dr Peoria IL 61614-2328 |
| Practice Telephone | 3096917855 |
| Practice Fax Number | 3096918853 |
| Mailing Telephone | 3096917855 |
| Mailing Fax Number | 3096918853 |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
IL | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922632371 | Richard Moon | Counselor | 2710 W Placita Mesa Alta, Tucson, AZ 85742-8736 | 2020-02-25 |
| 1043797723 | Richard Sloan Moon | Family Medicine | 202 W Caskey, Florence, TX 76527 | 2018-07-25 |
| 1942508734 | Richard David Moon | Psychologist | 1106 North Ave, Bridgeport, CT 06604-2710 | 2011-03-03 |
| 1346405834 | Richard L. Moon | Psychiatry & Neurology | 6402 Odana Rd, Madison, WI 53719-1123 | 2008-07-23 |
| 1699893446 | Richard B Moon | Pharmacist | 863 Fairmount Ave, Jamestown, NY 14701-2521 | 2007-03-27 |
| 1396893210 | Richard Wonsub Moon | Internal Medicine | 4647 Zion Ave, San Diego, CA 92120-2507 | 2007-01-08 |
| 1760566657 | Richard Moon | Anesthesiology | 2100 Erwin Rd, Durham, NC 27710-0001 | 2006-10-25 |
| 1356336762 | Richard Hyung Sung Moon | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 11 Nevins St, Brighton, MA 02135-3514 | 2005-09-13 |
| Street Address |
6712 N MOUNTELLO DR |
| City | PEORIA |
| State | IL |
| Zip Code | 61614-2328 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093931784 | Richard T. Moon, D.d.s., P.C. | Dentist | 6712 N Mountello Dr, Peoria, IL 61614-2328 | 2007-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548818511 | Christine Svoboda | Social Worker | 6919 N Knoxville Ave Ste 100 and 202, Peoria, IL 61614 | 2019-09-03 |
| 1639649007 | Kathy Karouzos Counseling, LLC | Clinic/Center | 330 W. Ivy Ln., Peoria, IL 61614 | 2018-11-28 |
| 1205312790 | Kathleen Marie Hendricks | Nurse Practitioner | 2809 W Willow Knolls Dr, Peoria, IL 61614 | 2018-07-17 |
| 1629563937 | Mary Elizabeth Cunningham | Counselor | 6219 N. Eldorado Dr., Peoria, IL 61614 | 2018-06-28 |
| 1861937955 | Angela Gilles | Social Worker | 6919 N Knoxville Ave Ste 100, Peoria, IL 61614 | 2016-12-27 |
| 1467994897 | Melissa Saxsma | Specialist | 5009 N Executive Dr, Peoria, IL 61614 | 2016-11-16 |
| 1902258874 | Rashid Plastic Surgery, LLC | Plastic Surgery | 804 W Trailcreek Drive, Peoria, IL 61614 | 2016-07-05 |
| 1215313143 | Melissa Lynn Phelan | Nurse Practitioner | 122 E Morningside Dr, Peoria, IL 61614 | 2015-08-03 |
| 1811380165 | All Ways Caring Services, Inc. | In Home Supportive Care | 6919 N Knoxville Ave, Suite 102, Peoria, IL 61614 | 2015-03-11 |
| 1568875920 | Schuler & Arkwell Orthodontic Partnership | Dentist | 2425 Cornerstone Ct. Ste. A, Peoria, IL 61614 | 2014-06-03 |
| Find all providers in zip 61614 | ||||
| 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 |
|---|---|---|---|---|
| 1013530187 | Core Family Dental, LLC | Dentist | 13460 N 94th Dr Ste K4, Peoria, AZ 85381-4249 | 2020-05-24 |
| 1982248084 | Westbrook Dental Center, P.a. | Dentist | 9276 W Union Hills Dr Ste A, Peoria, AZ 85382-8206 | 2019-10-31 |
| 1699318725 | Mint Dental Care LLC | Dentist | 8258 W Thunderbird Rd Ste 201, Peoria, AZ 85381-4777 | 2019-10-21 |
| 1548822497 | Katherine M Unes | Dentist | 11323 N Pawnee Rd, Peoria, IL 61615-9796 | 2019-07-01 |
| 1992296073 | George S Hariri | Dentist | 7777 W Deer Valley Rd Ste 160, Peoria, AZ 85382-2104 | 2018-05-23 |
| 1619485869 | Thunderbird Dental Studio | Dentist | 9179 W Thunderbird Rd Ste 107, Peoria, AZ 85381-4875 | 2018-01-22 |
| 1588179311 | Dr. Marc C Thevenin Jr. PC | Dentist | 5116 N Big Hollow Rd Ste 101, Peoria, IL 61615-3514 | 2017-12-01 |
| 1629592423 | Jessica Leigh Howard | Dentist | 7966 W Thunderbird Rd Ste 101, Peoria, AZ 85381-4902 | 2017-08-02 |
| 1588193718 | Darren Anderson | Dentist | 28451 N Vistancia Blvd Ste 101, Peoria, AZ 85383-2090 | 2017-06-10 |
| 1962943290 | Optim Dental Peoria-1 LLC | Dentist | 1200 W Main St Ste 9, Peoria, IL 61606-1218 | 2017-03-20 |
| Find all providers in PEORIA | ||||
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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.