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

Dr. Beau G Moody, DMD

Individual provider Dentist · NPI 1780917823

Dr. Beau G Moody, DMD is a Dentist in Edwardsville, Illinois. Practices as a sole proprietor and works from 2 locations. Licensed in Illinois.

Licensed in
IL
In the registry since
2009
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

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Practice location Address checks out

1811 Lindenwood Ave
Edwardsville, IL 62025-2580
Phone: (618) 659-0456
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 212 E Market St, Troy, IL 62294-1512 — (618) 667-6101

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 019.028093 (IL)

Record details

NPI number1780917823
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorYes
NPI enumeratedSeptember 8, 2009
Last updated in NPPESJune 15, 2021
Certification dateJune 15, 2021

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