DR. ALISA O MOORE (NPI# 1770674806) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770674806 |
| Entity Type | Individual |
| Full Name | DR. ALISA O MOORE |
| Credential | D.D.S. |
| Practice Address |
2440 Fairburn Rd Sw Suite 301 Atlanta GA 30331-5256 |
| Mailing Address |
Po Box 310065 Atlanta GA 31131-0065 |
| Practice Telephone | 4043497777 |
| Practice Fax Number | 4043498459 |
| Mailing Telephone | 4043497777 |
| Mailing Fax Number | 4043498459 |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
10731 | GA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750832168 | Alisa Fish Moore | Nurse Practitioner | 1405 Clifton Rd Ne, Atlanta, GA 30322-1060 | 2016-10-20 |
| Street Address |
2440 FAIRBURN RD SW SUITE 301 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30331-5256 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144321654 | Kaneta R Lott | Dentist | 2440 Fairburn Rd Sw, Suite 301, Atlanta, GA 30331-5256 | 2006-09-26 |
| 1710219118 | Lashandia Renae Brooks | Dentist | 2440 Fairburn Rd Sw, Suite 301, Atlanta, GA 30331-5256 | 2010-02-10 |
| 1972654044 | Family and Children's Dentistry, PC | Dentist | 2440 Fairburn Rd Sw, Suite 301, Atlanta, GA 30331-5256 | 2007-01-16 |
| 1154479418 | Kimberly E Beal | Dentist | 2440 Fairburn Rd Sw, Suite 301, Atlanta, GA 30331-5256 | 2007-01-05 |
| 1649328915 | Beverly C Rodgers | Dentist | 2440 Fairburn Rd Sw, Suite 301, Atlanta, GA 30331-5256 | 2007-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861001174 | Whitney Flemister | Social Worker | 3961 Princeton Lakes Way Sw, Atlanta, GA 30331 | 2020-07-23 |
| 1982237400 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 5829 Campbellton Road, S.w, Suite 110, Atlanta, GA 30331 | 2020-02-13 |
| 1295375558 | Drusilla Precious Cudjoe | Behavior Technician | 3800 Camp Creek Parkway Sw, Building 1400, Atlanta, GA 30331 | 2020-01-14 |
| 1497262778 | Champions Pharmacy | Pharmacy | 3886 Princeton Lakes Way Suite 180, Atlanta, GA 30331 | 2018-01-08 |
| 1033629779 | Carmen Ardoin | Counselor | 2636 Martin Luther King Jr. Drive, Suite 12, Atlanta, GA 30331 | 2017-10-09 |
| 1346759974 | Neva R Allison | Nurse Practitioner | 2611 Dayview Ln, Atlanta, GA 30331 | 2017-09-26 |
| 1538678255 | Natalie Mckay | Technician/Technologist | 3915 Cascade Rd, 220, Atlanta, GA 30331 | 2017-09-26 |
| 1700304268 | Tyrone Pipkin | Contractor | 415 Kendrick Terrace Sw, Atlanta, GA 30331 | 2017-09-05 |
| 1073031688 | Kristen Wooldridge | Pharmacist | 3695 Cascade Road, Atlanta, GA 30331 | 2017-09-04 |
| 1548704687 | Advance Pain Management | Health Maintenance Organization | 2950 Stone Hogan Road Connector, Atlanta, GA 30331 | 2016-12-08 |
| Find all providers in zip 30331 | ||||
| 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 |
|---|---|---|---|---|
| 1629619200 | Peachtree Hills Pediatric Dentistry | Dentist | 2385 Peachtree Rd Ne Ste A2ab, Atlanta, GA 30305-4139 | 2019-10-04 |
| 1952969396 | Ns3 Services, LLC | Dentist | 1039 Grant St Se Ste B11, Atlanta, GA 30315-2050 | 2019-05-31 |
| 1215336326 | Esther Lee | Dentist | 270 17th St Nw Unit 1706, Atlanta, GA 30363-1248 | 2014-08-14 |
| 1679993430 | Nikky Shotwell | Dentist | 2979 Silver Hill Ter., S.e., Atlanta, GA 30316-6715 | 2014-04-21 |
| 1932528577 | Jaha V Howard Dds LLC | Dentist | 4300 Paces Ferry Rd Se Ste 405, Atlanta, GA 30339-5759 | 2014-04-10 |
| 1790086668 | Dentistry for Children of Georgia LLC | Dentist | 1350 Spring St Nw Ste 600, Atlanta, GA 30309-2870 | 2010-11-09 |
| 1003123563 | Perimeter Pediatric Dentistry PC | Dentist | 2221 Johnson Ferry Rd Ne, Ste 2-a, Atlanta, GA 30319-2203 | 2010-09-07 |
| 1497905681 | David Michael Treff | Dentist | 4536 Chamblee Dunwoody Rd Ste 211, Atlanta, GA 30338-6201 | 2008-09-24 |
| 1780888693 | Teresa Danielle Jordan | Dentist | 2646 Gresham Rd Se, Atlanta, GA 30316-4148 | 2007-06-13 |
| 1659413953 | Ezat Mulki | Dentist | 1350 Spring St Nw, Ste 600, Atlanta, GA 30309-2864 | 2007-02-13 |
| Find all providers in ATLANTA | ||||
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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.