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RICHARD T. MOON, D.D.S., P.C.
NPI 1093931784
Dentist - General Practice in Peoria, IL

Active since April 18, 2007
6712 N MOUNTELLO DR, PEORIA, IL 61614(309) 691-7855(309) 691-8853 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Richard T. Moon, D.d.s., P.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RICHARD T. MOON, D.D.S., P.C. (NPI 1093931784) is a healthcare organization registered as a general practice in Peoria, Illinois and active in the NPI registry since April 2007. The organization lists Richard Thomas Moon, Dentist, as its authorized official.

NPPES Registry Identity

NPI1093931784
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameRICHARD T. MOON, D.D.S., P.C.
Location Address6712 N MOUNTELLO DRPeoria, IL 61614-2328
Mailing Address6712 N Mountello DrPeoria, IL 61614-2328 · (309) 691-7855 · Fax (309) 691-8853
Phone(309) 691-7855
Fax(309) 691-8853
Organization SubpartNo
Authorized OfficialRichard Thomas MoonDentist · (309) 691-7855
Enumeration DateApril 18, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1093931784 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
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.
6712 N MOUNTELLO DR, Peoria, IL 61614
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHAEL MOMCHEV DDS
Dentist (General Practice)
6712 N MOUNTELLO DR
PEORIA, IL 61614
Peoria County (309) 691-7855
DR. RICHARD T MOON DDS
Dentist (General Practice)
6712 N MOUNTELLO DR
PEORIA, IL 61614
Peoria County (309) 691-7855
SMALLTOWN DENTAL WILLOW KNOLLS LLC
Dentist (General Practice)
6712 N MOUNTELLO DR
PEORIA, IL 61614
Peoria County (309) 691-7855

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Richard T. Moon, D.D.S., P.C.'s NPI number?

The NPI number for Richard T. Moon, D.D.S., P.C. is 1093931784. It was assigned to this organization in the NPPES registry on April 18, 2007.

Where is Richard T. Moon, D.D.S., P.C. located?

Richard T. Moon, D.D.S., P.C. is located at 6712 N Mountello Dr, Peoria, IL 61614. The listed phone number is (309) 691-7855.

What is Richard T. Moon, D.D.S., P.C.'s specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Richard T. Moon, D.D.S., P.C. was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.