DR. FREDERICK THOMAS MOORE (NPI# 1174708010) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174708010 |
| Entity Type | Individual |
| Full Name | DR. FREDERICK THOMAS MOORE |
| Credential | D.M.D. |
| Practice Address |
173 Ashley Ave Bsb 249 Charleston SC 29425-8908 |
| Mailing Address |
173 Ashley Ave Bsb 249, Po Box 250507 Charleston SC 29425-8908 |
| Practice Telephone | 8437920693 |
| Practice Fax Number | 8437921280 |
| Mailing Telephone | 8437920693 |
| Mailing Fax Number | 8437921280 |
| Enumeration Date | 2008-01-09 |
| Last Update Date | 2008-01-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
17 | SC | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427695857 | Frederick Henry Moore Jr. | Specialist | 14000 Lakeside Cir, Sterling Heights, MI 48313-1320 | 2019-12-04 |
| 1497800403 | Frederick Dm Moore | Orthopaedic Surgery | 501 Hungerford Dr Apt 461, Rockville, MD 20850-5154 | 2007-01-23 |
| 1144380643 | Frederick Ernest Moore | Family Medicine | 189 County Park Rd., Yanceyville, NC 27379 | 2006-12-12 |
| 1215157060 | Frederick Moore | Dentist | 643 Main St, Palmetto, GA 30268-1138 | 2007-04-26 |
| 1992743850 | Frederick A Moore | Surgery | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2006-06-03 |
| 1104876440 | Frederick Stephen Moore | Internal Medicine | 2324 Limestone Overlook, Gainesville, GA 30501-7443 | 2006-05-10 |
| Street Address |
173 ASHLEY AVE BSB 249, |
| City | CHARLESTON |
| State | SC |
| Zip Code | 29425-8908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053303966 | Mullen O Coover | Dentist | 173 Ashley Ave, Bsb-335, Charleston, SC 29425-8908 | 2005-08-17 |
| 1093331472 | Austin Anthony Hughes | Dentist | 173 Ashley Ave, Charleston, SC 29425-8908 | 2020-06-22 |
| 1205489739 | Frances Gouldin | Dentist | 173 Ashley Ave, Charleston, SC 29425-8908 | 2019-07-23 |
| 1093105579 | Timothy Rohde | Dentist | 173 Ashley Ave, Bsb 546, Msc 507, Charleston, SC 29425-8908 | 2015-02-04 |
| 1639593254 | Medical University of South Carolina | Dentist | 173 Ashley Ave, Charleston, SC 29425-8908 | 2014-02-18 |
| 1194026153 | Medical University of Sc | Dentist | 173 Ashley Ave, Charleston, SC 29425-8908 | 2010-11-08 |
| 1780902734 | Jompobe Vuthiganon | Dentist | 173 Ashley Ave, Bsb Rm 546, Charleston, SC 29425-8908 | 2010-05-13 |
| 1558595074 | Mark Lane Mcentire | Dentist | 173 Ashley Ave, Charleston, SC 29425-8908 | 2009-05-12 |
| 1902069271 | Michael Kinon Lecholop | Dentist | 173 Ashley Ave, Charleston, SC 29425-8908 | 2008-07-08 |
| 1952517161 | Musc College of Dental Medicine | Clinic/Center | 173 Ashley Ave, Bsb 246, Charleston, SC 29425-0001 | 2007-05-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922607217 | Krishna Bhandari | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 10 Mcclennan Banks Drive, 2190-r, Msc 918, Charleston, SC 29425 | 2020-10-19 |
| 1649892456 | Mary Macrae Lynch | Social Worker | 179 Ashley Avenue, Charleston, SC 29425 | 2020-05-14 |
| 1528600053 | Amanda Watts | Physician Assistant | 135 Rutledge Ave. Msc 561, Charleston, SC 29425 | 2019-10-16 |
| 1851945497 | Kacy Wonder | Dentist | 173 Ashley Avenue Room 453 Msc 507, Charleston, SC 29425 | 2019-08-01 |
| 1477114569 | Justin Robert Silverman | Surgery | 169 Ashley Avenue, Room 202 Muh, Msc 333, Charleston, SC 29425 | 2019-06-28 |
| 1740840024 | Tyler Buckley | Surgery | 169 Ashley Ave, Room 202 Main Hospital, Msc333, Charleston, SC 29425 | 2019-06-18 |
| 1366001760 | Rayphael Sebastian Hardy | Internal Medicine | 169 Ashley Avenue Room 202 Main Hospital Msc333, Charleston, SC 29425 | 2019-06-10 |
| 1437718889 | Samar Medani | Internal Medicine | Division of Nephrology, Medical Univ of South Carolina, 96 Jonathan Lucas Street, Room 822, Msc 629, Charleston, SC 29425 | 2019-06-10 |
| 1427617950 | Emily Suzanne Nyers | Internal Medicine | 169 Ashley Ave., Room 202 Main Hospital, Msc 333, Charleston, SC 29425 | 2019-06-09 |
| 1790343564 | Alan Cowei Peh | Psychiatry & Neurology | 169 Ashley Avenue Rm 202, Main Hospital Msc 333, Charleston, SC 29425 | 2019-06-05 |
| Find all providers in zip 29425 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356963508 | Clements Ferry Dentistry LLC | Dentist | 1951 Clements Ferry Rd Ste 201, Charleston, SC 29492-8325 | 2020-05-11 |
| 1851945497 | Kacy Wonder | Dentist | 173 Ashley Avenue Room 453 Msc 507, Charleston, SC 29425 | 2019-08-01 |
| 1205290764 | Sloan Rehder | Dentist | 2051 Sam Rittenberg Blvd, Charleston, SC 29407-4683 | 2016-04-11 |
| 1679954705 | Coafs Lab | Dentist | 125 Wappoo Creek Dr Ste C1, Charleston, SC 29412-2161 | 2015-06-15 |
| 1952798357 | Now Or Never 2011, LLC | Dentist | 2270 Ashley Crossing Dr Ste 175, Charleston, SC 29414-5863 | 2015-04-23 |
| 1124296470 | M. Stephen Brandon, Dds LLC | Dentist | 1051 Gardner Rd Ste B, Charleston, SC 29407-5747 | 2008-02-20 |
| 1043409063 | Charleston Oral and Facial Surgery, Inc. | Dentist | 125 Wappoo Creek Dr, Suite 1, Charleston, SC 29412-2163 | 2007-10-16 |
| 1659442309 | Edward Elias Howard | Dentist | 1321 Virginia St E, Charleston, WV 25301 | 2006-11-13 |
| 1376614024 | Richard Lee Howard | Dentist | 1321 Virginia St East, Charleston, WV 25301 | 2006-11-13 |
| 1568543619 | Francis Simons Hane Jr. | Dentist | 96 Jonathan Lucas, Charleston, SC 29425 | 2006-10-17 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 29425 |
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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.