Dr. Ethan Embrey Moore is a Columbia, Mississippi based Dentist who is specialized in
General Practice Dentistry. He does not accept the Medicare-approved amount. Patients will be billed for the treatment. Active license number of Dr. Ethan Embrey Moore is
4212-21 for General Practice Dentistry in Mississippi. His current practice location is
430 Broad St, Columbia. Patients can reach him at
601-736-7125.
Dr. Ethan Embrey Moore is the primary dental care provider for patients of all ages. He is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Profile:
Dr. Ethan Embrey Moore speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
| Name: | Dr. Ethan Embrey Moore |
| Specialization: | Dentist |
| Gender: | Male |
| Credentials: | DMD |
| Accepts Medicare Assignment: | No |
| Practice Address: | 430 Broad St, Columbia,
Mississippi, 39429-3006 |
| Phone: | 601-736-7125 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| NPI Number: | 1710555115 |
| NPI Enumeration Date: | 14 Jun, 2021 |
| NPI Last Update On: | 07 Jul, 2025 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Ethan Embrey Moore are as mentioned below.
| License Number | Specialization | State | Status | |
| 4212-21 | General Practice Dentistry | Mississippi | Primary | |
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 430 Broad St,
Columbia, Mississippi |
| Zip: | 39429-3006 |
| Phone Number: | 601-736-7125 |
Patients can reach Dr. Ethan Embrey Moore at
430 Broad St, Columbia, Mississippi or can
call to book an appointment on 601-736-7125.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.