THOMAS H. MOORE DDS LTD (NPI# 1639202914) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639202914 |
| Entity Type | Organization |
| Organization Name | THOMAS H. MOORE DDS LTD |
| Practice Address |
6075 Vantage Pl Rockford IL 61107-5905 |
| Mailing Address |
4298 Windswept Way Loves Park IL 61111-8654 |
| Practice Telephone | 8153990677 |
| Mailing Telephone | 8156366673 |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. RYAN THOMAS MOORE (PRESIDENT) |
| Authorized Official Telephone | 8153990677 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Street Address |
6075 VANTAGE PL |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61107-5905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891897799 | Kelly J. Moore D.d.s., P.C. | Dentist | 6075 Vantage Pl, Rockford, IL 61107-5905 | 2006-09-01 |
| 1558814897 | Thomas H. Moore D.d.s. Ltd | Dentist | 6075 Vantage Pl, Rockford, IL 61107-5905 | 2016-08-03 |
| 1811348287 | Samuel Moore Wallden | Dentist | 6075 Vantage Pl, Rockford, IL 61107-5905 | 2016-06-28 |
| 1487788709 | Lindsay Danielle Moore | Dentist | 6075 Vantage Pl, Rockford, IL 61107-5905 | 2007-03-16 |
| 1588798813 | Ryan Thomas Moore | Dentist | 6075 Vantage Pl, Rockford, IL 61107-5905 | 2007-03-16 |
| 1366575722 | Tom Harold Moore | Dentist | 6075 Vantage Pl, Rockford, IL 61107-5905 | 2007-03-14 |
| 1396847216 | Kelly James Moore | Dentist | 6075 Vantage Pl, Rockford, IL 61107-5905 | 2006-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356952139 | Jessica Marie Tamayo Fernandez | Pharmacist | 1145 Alpine Rd, Rockford, IL 61107 | 2020-08-13 |
| 1467092379 | Unknown Safa Fatima | Student in an Organized Health Care Education/Training Program | Mercyhealth Mulford Clinic, 5970 Churchview Drive, Rockford, IL 61107 | 2020-01-08 |
| 1194367912 | Matt J Kriebs | Nurse Practitioner | 1235 N Mulford Rd Suite 103, Rockford, IL 61107 | 2019-10-14 |
| 1265962336 | Mary Golembeck | Nurse Practitioner | 7290 Argus Dr, Rockford, IL 61107 | 2017-06-12 |
| 1831644749 | Tessa Lee | Occupational Therapist | 3422 Lauderdale Ln, Rockford, IL 61107 | 2016-08-20 |
| 1942626965 | Elevated Health Essentials, LLC | Chiropractor | 124 N Water St Ste 204e, Rockford, IL 61107 | 2014-03-14 |
| 1093139909 | Swedishamerican Hospital | Surgery | 1639 N Alpine Rd Ste 400, Rockford, IL 61107 | 2014-02-12 |
| 1346676582 | Christopher Anthony Ziganto | Pharmacist | 494 Bienterra Trail #2, Rockford, IL 61107 | 2013-09-19 |
| 1023358272 | Lavanya Durairajan | Physical Therapist | 7358 Shiligton Dr, Rockford, IL 61107 | 2013-02-26 |
| 1851523146 | Great Smiles of Rockford | Durable Medical Equipment & Medical Supplies | 780 N. Mulfrord Road, Rockford, IL 61107 | 2009-08-20 |
| Find all providers in zip 61107 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841616661 | Ideal Dental Care PC | Clinic/Center | 5876 E State St, Rockford, IL 61108-2428 | 2014-03-18 |
| 1669094041 | Cherryvale Dental Center LLC | Clinic/Center | 1957 Pawlisch Dr, Rockford, IL 61112-1067 | 2020-05-08 |
| 1932666922 | Robert Busan Dds, Pllc | Clinic/Center | 4035 Morsay Dr Ste 1, Rockford, IL 61107-4875 | 2019-02-26 |
| 1730676990 | Alex Moore, Dmd PC | Clinic/Center | 6050 Brynwood Dr Ste 205, Rockford, IL 61114 | 2018-04-13 |
| 1689824898 | Corey J Brenner Dds Pllc | Clinic/Center | 9000 Walnut St, Box 236, Rockford, MN 55373-0236 | 2008-09-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124629514 | Chicago Pediatric Dentistry and Orthodontics | Clinic/Center | 1136 S Delano Ct W Ste B202, Chicago, IL 60605-3734 | 2020-11-03 |
| 1437750031 | Secure Dental Xi | Clinic/Center | 1843 W Golf Rd, Schaumburg, IL 60194-1148 | 2020-11-02 |
| 1780283267 | Jenna Gaw, Dds, Pllc | Clinic/Center | 1724 Locust Pl Apt 303, Schaumburg, IL 60173-4239 | 2020-10-26 |
| 1740889344 | Nsp Dental LLC | Clinic/Center | 1900 Hollister Dr Ste 190, Libertyville, IL 60048-5283 | 2020-10-23 |
| 1285232827 | Paul Doodes Dds Phd PC | Clinic/Center | 45 S Park Blvd Ste 190, Glen Ellyn, IL 60137-6282 | 2020-10-15 |
| 1780290676 | Great Smile Dental Pllc | Clinic/Center | 720 Osterman Ave Ste 304, Deerfield, IL 60015-4339 | 2020-09-16 |
| 1669087375 | Naperville Smiles Dental | Clinic/Center | 8 W Gartner Rd Ste 124, Naperville, IL 60540-7549 | 2020-09-09 |
| 1649883364 | Mark J Maly Estate | Clinic/Center | 103 S Main St # Po, Orangeville, IL 61060-9244 | 2020-08-24 |
| 1760094718 | Stoffel and Tomazin Dental Associates, Ltd | Clinic/Center | 5718 W 35th St, Cicero, IL 60804-4222 | 2020-08-20 |
| 1215548771 | Meda Dental II LLC | Clinic/Center | 2735 Hassert Blvd Ste 159, Naperville, IL 60564-5205 | 2020-08-10 |
| 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.