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Deactivated NPI 1619040128 Deactivated / Inactive NPI Male Practitioner

Dr. Michael David Moore , DDS

Dentist • Elk Grove, CA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Michael Moore has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date November 15, 2006
NPI Deactivation Date January 25, 2023
Total Practice Duration ~17 Years of Practice (2006 – 2023)

Professional Overview & Biography Verified Profile Summary

Dr. Michael Moore, DDS was a registered Dentist practicing in Elk Grove, CA. Throughout an active medical career spanning 17 years, Dr. Moore provided care at the practice location at 9727 ELK GROVE FLORIN RD until profile deactivation on 2023-01-25.

Practice Location & Contact Primary Location

Practice Address

9727 Elk Grove Florin Rd
Suite 115

Elk Grove, CA 956242264

Telephone 9166868540
Fax 8016404766
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Elk Grove, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 14.4 Yrs
Regional Practice Density
63 Specialists

Practicing in Elk Grove, CA (15331 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License CA 28475

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

11 Associated Practitioners
Theodore Celeste , BCTMB

Massage Therapist

NPI 1073051181
Dr. Peter Ngai , DMD

Dentist - General Practice

NPI 1083606388

Doctor of Dental Medicine

NPI 1104820950

Doctor of Optometry

Dr. Roger Reich , DDS

Dentist - General Practice

NPI 1154430403

Doctor of Dental Surgery

Dr. Penny Phipps , DDS

Dentist - General Practice

NPI 1265424568

Doctor of Dental Surgery

Dr. Janet Yu , MD

Family Medicine

NPI 1417972472

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
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NPI Profile Deactivated January 25, 2023

Record deactivated on January 25, 2023

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Medical Taxonomy / Specialty Registered (Primary Specialty) December 10, 2022

Dentist (License #28475 in CA)

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 9727 ELK GROVE FLORIN RD, SUITE 115, ELK GROVE, CA 956242264 (Tel: 9166868540)

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Updated Business Mailing Address July 08, 2007

Registered at 9727 ELK GROVE FLORIN RD, SUITE 115, ELK GROVE, CA 956242264 (Tel: 9166868540)

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Provider Name / Credentials Updated July 08, 2007

Recorded as MICHAEL MOORE, DDS

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #28475 in CA)

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Initial NPI Registration & Enumeration November 15, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1619040128
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 15, 2006
Last Update: July 08, 2007
Deactivation Date: January 25, 2023

Mailing Address

9727 Elk Grove Florin Rd, Suite 115

Elk Grove, CA 956242264

Phone: 9166868540

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.