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

Dr. Ethan Embrey Moore, DMD

Individual provider General Practice Dentistry · NPI 1710555115

Dr. Ethan Embrey Moore, DMD is a General Practice Dentistry in Columbia, Mississippi. Licensed in Mississippi. Registered with an NPI since 2021.

Licensed in
MS
In the registry since
2021
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

See every abbreviation used in this directory →

Practice location Address checks out

430 Broad St
Columbia, MS 39429-3006
Phone: (601) 736-7125
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 4212-21 (MS)

Record details

NPI number1710555115
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorNo
NPI enumeratedJune 14, 2021
Last updated in NPPESJuly 7, 2025
Certification dateJuly 7, 2025
Mailing address430 Broad St, Columbia, MS 39429-3006

Other providers in Columbia