KELLIE LYNN MOORE
NPI 1942705140
Dentist - Oral and Maxillofacial Surgery in Chicago, IL

Q: What is Kellie Moore's NPI number?

The NPI number for Kellie Moore is 1942705140. It was assigned to this individual provider in the NPPES registry on March 28, 2018.

Q: What is Kellie Moore's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Q: When was this NPI record last updated?

The NPPES record for Kellie Moore was last updated on June 22, 2021. 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.

Active since March 28, 2018

251 E HURON ST, CHICAGO, IL 60611(312) 926-2000 Get Directions Write a Review

NPPES record last updated: June 22, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 22, 2021, Jul 3, 2018, Mar 28, 2018 (3 updates tracked since 2018).

On this page

About Kellie Lynn Moore NPPES

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

KELLIE LYNN MOORE (NPI 1942705140) is an individual oral and maxillofacial surgery provider in Chicago, Illinois, licensed in Illinois (019031614) and active in the NPI registry since March 2018.

NPPES Registry Identity

NPI1942705140

Entity TypeIndividualFemale

Primary Taxonomy1223S0112X

Provider Legal NameKELLIE LYNN MOORE

Location Address251 E HURON STChicago, IL 60611

Mailing Address251 E Huron StChicago, IL 60611-3055 · (312) 926-2000

Phone(312) 926-2000

Sole ProprietorNo

Enumeration DateMarch 28, 2018

Last NPPES UpdateJune 22, 20213 updates tracked since enumeration

NPPES CertifiedJune 22, 2021

✔ NPI 1942705140 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers

Taxonomy Code1223S0112X

License✔ Licensed in IL · 019031614

Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

Also ListedDentist · General PracticeTaxonomy 1223G0001X · License 019031614 (IL)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

251 E HURON ST, Chicago, IL 60611

Open in Google Maps ↗

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.

MARK WANG M.D.

Pathology (Anatomic Pathology & Clinical Pathology)

251 E HURON ST, FEINBERG PAVILION
CHICAGO, IL 60611

Cook County (312) 503-8144

DR. MARLEY ANN DOYLE M/D.

Psychiatry & Neurology (Psychiatry)

251 E HURON ST, GALTER 3-150, C
CHICAGO, IL 60611

Cook County (312) 926-6895

CASSIDY SCHWAB MD

Anesthesiology