Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Beverly Moon DMD LLC

Organization Dental Clinic/Center · NPI 1962037523

Beverly Moon DMD LLC is a Dental Clinic/Center in Overland Park, Kansas. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4601 W 109th St Ste 240
Overland Park, KS 66211-1323
Phone: (913) 338-3384
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dental Clinic/Center (primary) Taxonomy 261QD0000X

Record details

NPI number1962037523
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Beverly Moon — Dentist · (732) 754-1998
NPI enumeratedMarch 4, 2020
Last updated in NPPESMarch 4, 2020
Certification dateMarch 4, 2020
Mailing address16424 Lucille St, Overland Park, KS 66221-7032

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