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

Dr. Kelly James Moore, DDS

Individual provider General Practice Dentistry · NPI 1396847216

Dr. Kelly James Moore, DDS is a General Practice Dentistry in Rockford, Illinois. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2006
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

6075 Vantage Pl
Rockford, IL 61107-5905
Phone: (815) 399-9040
Fax: (815) 399-9336
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X (IL)

Record details

NPI number1396847216
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorYes
NPI enumeratedSeptember 1, 2006
Last updated in NPPESJuly 8, 2007
Mailing address404 James Ave, Rockford, IL 61107-4626

Other providers in Rockford