DR. SUSANNE REYNOLDS MOORE (NPI# 1801930532) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801930532 |
| Entity Type | Individual |
| Full Name | DR. SUSANNE REYNOLDS MOORE |
| Credential | DMD |
| Practice Address |
1149 Old Fannin Rd Suite 26 Brandon MS 39047 |
| Mailing Address |
1149 Old Fannin Road Suite 26 Brandon MS 39047 |
| Practice Telephone | 6019927972 |
| Practice Fax Number | 6019927972 |
| Mailing Telephone | 6019927972 |
| Mailing Fax Number | 6019927972 |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
304598 | MS | Dental Providers |
| Street Address |
1149 OLD FANNIN RD SUITE 26 |
| City | BRANDON |
| State | MS |
| Zip Code | 39047 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376089904 | Hazel Mccaughan | Dentist | 1149 Old Fannin Rd, #26, Brandon, MS 39047-9244 | 2017-01-06 |
| 1922254929 | Back Care Center, Inc. | Chiropractor | 1149 Old Fannin Rd, Suite 22, Brandon, MS 39047-9244 | 2008-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396368783 | Siyuan Chen Kennedy | Counselor | 108 Sandstone Drive, Brandon, MS 39047 | 2020-05-20 |
| 1568019784 | Juarez Brown Emerson | Registered Nurse | 426 Pinebrook Circle, Brandon, MS 39047 | 2019-08-22 |
| 1649764127 | Specialty Diagnostics LLC | Family Medicine | 1149 Old Fannin Rd Ste 22, Brandon, MS 39047 | 2018-06-19 |
| 1528423035 | Kathlene Strangeman | Social Worker | 111 Lakeshore Dr Apt G403, Brandon, MS 39047 | 2015-12-28 |
| 1174935076 | Anthony Davis | Counselor | 198 Bellegrove Cir, Brandon, MS 39047 | 2014-05-27 |
| 1144659178 | Medical Foundation of Central Ms, Inc | Family Medicine | 1887 Spillway Rd., Brandon, MS 39047 | 2013-11-12 |
| 1437429941 | Picton Timothy Evans | Pharmacist | 150 B Cumberland Ed, Brandon, MS 39047 | 2012-01-01 |
| 1275828030 | Kathryn Audell Piburn | Nurse Practitioner | 1887 Spillway Rd Ste 140, Brandon, MS 39047 | 2011-06-09 |
| 1194898429 | Brookshire Grocery Company | Durable Medical Equipment & Medical Supplies | 143 Plaza Drive Ext, Attention Pharmacy Dept, Brandon, MS 39047 | 2006-11-16 |
| 1972530632 | Claudia Weir Anthony | Nurse Practitioner | 1887 Spillway Rd, Brandon, MS 39047 | 2006-06-27 |
| Find all providers in zip 39047 | ||||
| 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 |
|---|---|---|---|---|
| 1255955340 | Terah Shelby | Dentist | 2139 Highway 471, Brandon, MS 39047-8748 | 2020-06-03 |
| 1831744655 | Brandon Modern Dentistry, Pa | Dentist | 971 E. Bloomingdale Avenue, Brandon, FL 33511 | 2019-08-08 |
| 1992368112 | Donna Mansour | Dentist | 971 E Bloomingdale Ave, Brandon, FL 33511-8118 | 2019-04-15 |
| 1538672787 | Brandon Smiles LLC | Dentist | 926 West Lumsden Rd, Brandon, FL 33511 | 2017-11-09 |
| 1770009649 | Arnold Dentistry, Pa | Dentist | 330 E Bloomingdale Ave, Brandon, FL 33511-8155 | 2017-08-22 |
| 1679003768 | Jay Ghiya | Dentist | 10955 Causeway Blvd, Brandon, FL 33511-1997 | 2017-06-13 |
| 1497106033 | Affiliated Dental Specialist | Dentist | 2488 W Brandon Blvd Ste B, Brandon, FL 33511-4710 | 2016-06-24 |
| 1699150110 | Shadan Hafsa | Dentist | 611 E Bloomingdale Ave Ste C, Brandon, FL 33511-8127 | 2015-07-26 |
| 1427439835 | Daniel Ray Carney | Dentist | 100 Avalon Ct Ste A, Brandon, MS 39047-7672 | 2015-06-11 |
| 1770982183 | Maria Yatzkan | Dentist | 2118 W Brandon Blvd., Brandon, FLORIDA 33511 | 2014-08-21 |
| Find all providers in BRANDON | ||||
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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.