Dr Brenden Delaney Moon, DMD is a medicare enrolled "Dentist" provider in Carthage, Illinois. His current practice location is
671 Wabash Ave, Carthage, Illinois. You can reach out to his office (for appointments etc.) via phone at
(217) 357-2171.
Dr Brenden Delaney Moon is licensed to practice in Illinois (license number 019027433) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1730375171.
Healthcare Provider's Profile
Full Name | Dr Brenden Delaney Moon |
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Gender | Male |
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Speciality | Dentist |
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Location | 671 Wabash Ave, Carthage, Illinois |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1730375171
- Provider Enumeration Date: 09/19/2007
- Last Update Date: 09/07/2011
Medicare PECOS Information:
- PECOS PAC ID: 9335460773
- Enrollment ID: I20150610001283
Medical Identifiers
Medical identifiers for Dr Brenden Delaney Moon such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1730375171 | NPI | - | NPPES |
9202327 | Medicaid | IL | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
122300000X | Dentist | 019027433 (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Brenden Delaney Moon is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Brenden Delaney Moon, DMD 671 Wabash Ave, Po Box 357, Carthage, IL 62321 Ph: (217) 357-2171 | Dr Brenden Delaney Moon, DMD 671 Wabash Ave, Carthage, IL 62321 Ph: (217) 357-2171 |
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