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DR. LISA MARIE MOORE DDS
NPI 1407875891
Dentist - Pediatric Dentistry in South Bend, IN

Active since July 18, 2006
1005 E LASALLE AVE, SOUTH BEND, IN 46617(574) 245-7501(574) 245-7502 Get Directions Write a Review

NPPES record last updated: July 9, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Lisa Marie Moore Dds NPPES

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

DR. LISA MARIE MOORE DDS (NPI 1407875891) is an individual pediatric dentistry provider in South Bend, Indiana, licensed in Indiana (12009706) and active in the NPI registry since July 2006.

NPPES Registry Identity

NPI1407875891
Entity TypeIndividualFemale
Primary Taxonomy1223P0221X
Provider Legal NameDR. LISA MARIE MOORECredential: DDS
Location Address1005 E LASALLE AVESouth Bend, IN 46617-2818
Mailing Address1005 E Lasalle AveSouth Bend, IN 46617-2818 · (574) 245-7501 · Fax (574) 245-7502
Phone(574) 245-7501
Fax(574) 245-7502
Sole ProprietorNo
Enumeration DateJuly 18, 2006
Last NPPES UpdateJuly 9, 2007
✔ NPI 1407875891 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
License✔ Licensed in IN · 12009706
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
1005 E LASALLE AVE, South Bend, IN 46617
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Other Providers at the Same Location NPPES 15

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

DR. RICHARD COHEN DDS
Dentist (Pediatric Dentistry)
1005 E LASALLE AVE
SOUTH BEND, IN 46617
St. Joseph County (574) 245-7501
DR. ROBERT S. AUSTGEN DDS
Dentist (Pediatric Dentistry)
1005 E LASALLE AVE
SOUTH BEND, IN 46617
St. Joseph County (574) 245-7501
CHARLES ROSENBAUM D.D.S.
Dentist (Pediatric Dentistry)
1005 E LASALLE AVE
SOUTH BEND, IN 46617
St. Joseph County (574) 245-7501
DR. THOMAS PEDAVOLI DDS
Dentist (General Practice)
1005 E LASALLE AVE
SOUTH BEND, IN 46617
St. Joseph County (574) 245-7503
DR. RONALD STANGEBYE DDS
Dentist (General Practice)
1005 E LASALLE AVE
SOUTH BEND, IN 46617
St. Joseph County (574) 245-7503
DR. MICHAEL LITTELL DDS
Dentist (General Practice)
1005 E LASALLE AVE
SOUTH BEND, IN 46617
St. Joseph County (574) 245-7501
THE DENTAL CENTER OF SOUTH BEND LLC
Dentist (Pediatric Dentistry)
1005 E LASALLE AVE
SOUTH BEND, IN 46617
St. Joseph County (574) 245-7501
DR. GARY R. PIPPENGER DDS
Dentist (Pediatric Dentistry)
1005 E LASALLE AVE
SOUTH BEND, IN 46617
St. Joseph County (574) 245-7503

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 Lisa Moore's NPI number?

The NPI number for Lisa Moore is 1407875891. It was assigned to this individual provider in the NPPES registry on July 18, 2006.

Where is Lisa Moore located?

Lisa Moore practices at 1005 E Lasalle Ave, South Bend, IN 46617. The listed phone number is (574) 245-7501.

What is Lisa Moore's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

What insurance does Lisa Moore accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and BEST Life and 11 other insurers list Lisa Moore as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lisa Moore was last updated on July 9, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.