DR. KENNETH EARL MOORE DDS
NPI 1811035306
Dentist in Roseville, CA
About Dr. Kenneth Earl Moore Dds NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. KENNETH EARL MOORE DDS (NPI 1811035306) is an individual dentist in Roseville, California, licensed in California (CA30946) and active in the NPI registry since February 2007. He has opted out of Medicare through February 24, 2028 and remains eligible to order and refer.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Dr. Kenneth Earl Moore Dds has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 24, 2014 through February 24, 2028.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 95661 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
ROSEVILLE, CA 95661
ROSEVILLE, CA 95661
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 Kenneth Moore's NPI number?
The NPI number for Kenneth Moore is 1811035306. It was assigned to this individual provider in the NPPES registry on February 5, 2007.
Where is Kenneth Moore located?
Kenneth Moore practices at 729 Sunrise Ave Ste #400, Roseville, CA 95661. The listed phone number is (916) 780-2022.
What is Kenneth Moore's specialty?
The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.
Is Kenneth Moore enrolled in Medicare?
No. Kenneth Moore has opted out of Medicare through February 24, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.
When was this NPI record last updated?
The NPPES record for Kenneth Moore 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.
# Dr. Kenneth Earl Moore, DDS · NPI 1811035306
Dentist provider in Roseville, California. Individual provider, active in the CMS NPPES registry since February 5, 2007.
## Identity
- **NPI:** 1811035306 (Entity type: Individual)
- **Enumerated:** February 5, 2007
- **Primary specialty:** Dentist · taxonomy 122300000X
- **State license:** CA30946 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 729 SUNRISE AVE, STE #400, Roseville, CA 95661-4526
- **Phone:** (916) 780-2022 · **Fax:** (916) 784-7491
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through February 24, 2028); services are provided under private contract
## Record status
- **NPPES last updated:** July 8, 2007
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Source: [NPI Profile](https://npiprofile.com/npi/1811035306) · Data from the CMS NPPES public registry.