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Deactivated NPI 1710288873 Deactivated / Inactive NPI Female Practitioner

Dr. Jacquelyn Marie Moore , DDS

Dentist - General Practice • Meridian, MS

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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. Jacquelyn Moore has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date November 05, 2010
NPI Deactivation Date January 23, 2025
Total Practice Duration ~15 Years of Practice (2010 – 2025)

Professional Overview & Biography Verified Profile Summary

Dr. Jacquelyn Moore, DDS was a registered Dentist - General Practice practicing in Meridian, MS. Throughout an active medical career spanning 15 years, Dr. Moore provided care at the practice location at 2310 4TH ST until profile deactivation on 2025-01-23.

Practice Location & Contact Primary Location

Practice Address

2310 4th St
Ste. B

Meridian, MS 393015819

Telephone 6016934878
Fax 6016934337
Associated Practice Facility / Clinic
🏢 Magnolia Foot Clinic Llc Facility NPI 1699070326

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Meridian, MS

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 20.3 Yrs
Regional Practice Density
27 Specialists

Practicing in Meridian, MS (895 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 - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License MS 2678-92

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.

Practice Associates & Co-Workers

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

1 Associated Practitioners
Dr. Eugene Hunter , DDS

Dentist - General Practice

NPI 1326349473

Doctor of Dental Surgery

Career & Practice History Timeline

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

12 Historical Events
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NPI Profile Deactivated January 23, 2025

Record deactivated on January 23, 2025

NPI Profile Active February 16, 2017

NPI status registered as active in NPPES database

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Updated Practice Location February 16, 2017

Registered at 2310 4TH ST, STE. B, MERIDIAN, MS 393015819 (Tel: 6016934878)

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Updated Business Mailing Address February 16, 2017

Registered at 2310 4TH ST, B, MERIDIAN, MS 393015819 (Tel: 6016934878)

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Provider Name / Credentials Updated February 16, 2017

Recorded as JACQUELYN HUNTER-MOORE, DDS

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Medical Taxonomy / Specialty Registered (Primary Specialty) February 16, 2017

Dentist (License #2678-92 in MS)

NPI Profile Active November 05, 2010

NPI status registered as active in NPPES database

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Updated Practice Location November 05, 2010

Registered at 2310 4TH ST, STE. B, MERIDIAN, MS 393015819 (Tel: 6016934878)

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Updated Business Mailing Address November 05, 2010

Registered at 2310 4TH ST, B, MERIDIAN, MS 393015819 (Tel: 6016934878)

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Provider Name / Credentials Updated November 05, 2010

Recorded as JACQUELYN MOORE, DDS

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Medical Taxonomy / Specialty Registered (Primary Specialty) November 05, 2010

Dentist (License #2678-92 in MS)

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Initial NPI Registration & Enumeration November 05, 2010

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: 1710288873
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 05, 2010
Last Update: November 05, 2010
Deactivation Date: January 23, 2025

Mailing Address

2310 4th St, B

Meridian, MS 393015819

Phone: 6016934878

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.