Dr. Regan L Moore
Periodontist
501 S Preston St
Louisville
, Kentucky 40292-0001
Dr. Regan L Moore
Periodontist
501 S Preston St
Louisville
, Kentucky 40292-0001
(502) 852-7163
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About
Features
Specialties
- Periodontist
Languages spoken
- English
Location
First Address
- Dr. Regan L Moore
- 501 S Preston St
- Louisville, KY
- Zip : 40292-0001
- Fax : (502) 852-7163
- Phone : (502) 852-5128
Second Address
- Dr. Regan L Moore
- 501 S Preston St
- Louisville, KY
- Zip : 40292-0001
- Fax : (502) 852-7163
- Phone : (502) 852-5128
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0300X | Periodontist | 5947 | KY |
National Provider Identifier
| NPI | 1093853095 |
|---|---|
| Provider Name | Dr. Regan L Moore |
| First Address | Louisville, KY 40292-0001 |
| Second Address | Louisville, KY 40292-0001 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 02/02/2007 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 6003670 | (05) | KY |
| 9179124 | DORAL DENTAL (01) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.