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Deactivated NPI 1689123556 Deactivated / Inactive NPI Male Practitioner

Harvey Roy Moon

Dental Assistant • Ft Gordon, GA

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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, Harvey Moon has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 03, 2016
NPI Deactivation Date November 22, 2019
Total Practice Duration ~3 Years of Practice (2016 – 2019)

Professional Overview & Biography Verified Profile Summary

Harvey Moon was a registered Dental Assistant practicing in Ft Gordon, GA. Throughout an active medical career spanning 3 years, Harvey Moon provided care at the practice location at BLDG 38801 ACADEMIC DR, SUITE B & C until profile deactivation on 2019-11-22.

Practice Location & Contact Primary Location

Practice Address

Bldg 38801 Academic Dr, Suite B & C
Usa Dentac

Ft Gordon, GA 309055660

Telephone 7067876927
Fax 7067872082

Specialty Benchmarks & Practice Insights

Comparative analytics for Dental Assistant in Ft Gordon, GA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
9 Specialists

Practicing in Ft Gordon, GA (93 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

Dental Assistant Primary Specialty

NUCC Taxonomy Code: 126800000X

An individual who may or may not have completed an accredited dental assisting education program and who aids the dentist in providing patient care services and performs other nonclinical duties in the dental office or other patient care facility. The scope of the patient care functions that may be legally delegated to the dental assistant varies based on the needs of the dentist the educational preparation of the dental assistant and state dental practice acts and regulations. Patient care services are provided under the supervision of a dentist. To avoid misleading the public, no occupational title other than dental assistant should be used to describe this dental auxiliary.

Practice Associates & Co-Workers

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

40 Associated Practitioners
Dr. Jeffrey Chang , DDS

Dentist - Prosthodontics

NPI 1003036286

Doctor of Dental Surgery

NPI 1013420462
NPI 1013988153

Doctor of Dental Surgery

Dr. Daniel Dunham , DDS

Dentist - Prosthodontics

NPI 1013996081

Doctor of Dental Surgery

Dr. Frederick Bisch , DMD

Dentist - Periodontics

NPI 1033196159

Doctor of Dental Medicine

NPI 1043280993

Doctor of Dental Medicine

Career & Practice History Timeline

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

7 Historical Events
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NPI Profile Deactivated November 22, 2019

Record deactivated on November 22, 2019

NPI Profile Active October 03, 2016

NPI status registered as active in NPPES database

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Updated Practice Location October 03, 2016

Registered at BLDG 38801 ACADEMIC DR, SUITE B & C, USA DENTAC, FT GORDON, GA 309055660 (Tel: 7067876927)

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Updated Business Mailing Address October 03, 2016

Registered at BLDG 38801 ACADEMIC DR, SUITE B & C, USA DENTAC, FT GORDON, GA 309055660 (Tel: 7067876927)

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Provider Name / Credentials Updated October 03, 2016

Recorded as HARVEY MOON

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Medical Taxonomy / Specialty Registered (Primary Specialty) October 03, 2016

Dental Assistant

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Initial NPI Registration & Enumeration October 03, 2016

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: 1689123556
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 03, 2016
Last Update: October 03, 2016
Deactivation Date: November 22, 2019

Mailing Address

Bldg 38801 Academic Dr, Suite B & C, Usa Dentac

Ft Gordon, GA 309055660

Phone: 7067876927

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.