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DR. RICHARD T MOON DDS
NPI 1639220833
Dentist - General Practice in Peoria, IL

Active since January 15, 2007
6712 N MOUNTELLO DR, PEORIA, IL 61614(309) 691-7855(309) 691-8853 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Richard T Moon Dds NPPES

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

DR. RICHARD T MOON DDS (NPI 1639220833) is an individual general practice provider in Peoria, Illinois and active in the NPI registry since January 2007.

NPPES Registry Identity

NPI1639220833
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. RICHARD T MOONCredential: DDS
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
Sole ProprietorNo
Enumeration DateJanuary 15, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1639220833 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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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
RICHARD T. MOON, D.D.S., P.C.
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 Moon's NPI number?

The NPI number for Richard Moon is 1639220833. It was assigned to this individual provider in the NPPES registry on January 15, 2007.

Where is Richard Moon located?

Richard Moon practices at 6712 N Mountello Dr, Peoria, IL 61614. The listed phone number is (309) 691-7855.

What is Richard Moon'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 Moon was last updated on July 8, 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.