Gerald Rodger Moon, DDS

Dentist · Peoria, IL

Individual Active NPI

NPI number 1669516688

Practice location

2809 W Willow Knolls Rd
G Rodger Moon DDS
Peoria, IL 61614
Phone
(309) 682-2090
Fax
(309) 682-0903

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NPI record

NPI
1669516688
Entity type
Individual (Type 1)
Enumeration date
February 16, 2007
Last updated
July 8, 2007
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X 19A13409 IL

About Dr. Moon

Gerald Rodger Moon, DDS is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 2809 W Willow Knolls Rd, G Rodger Moon DDS, Peoria, IL 61614. The NPI number 1669516688 was assigned on February 16, 2007 and the record was last updated on July 8, 2007.

Dr. Moon lists a license in the registry: #19A13409 (IL) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Gerald Rodger Moon, DDS?

The NPI number is 1669516688.

What is the phone number of Dr. Moon?

The phone number listed for the practice location is (309) 682-2090.

Where is Dr. Moon located?

2809 W Willow Knolls Rd, G Rodger Moon DDS, Peoria, IL 61614.

What is the taxonomy code for Dr. Moon?

The primary taxonomy code is 122300000X – Dentist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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