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Dr. Kelly Rae Moore , DDS

Dentist • Mound, MN

Active NPI 1790277416 Individual Practitioner Female Practitioner
Practice location in NPPES

5205 Shoreline Dr
Mound, MN 553641770

Call 9528312800 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

5205 Shoreline Dr

Mound, MN 553641770

Telephone 9528312800
Organization at the Same NPPES Address or Phone
West Lakes Dentistry, Pa Facility NPI 1497113674

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 1 additional practice-address record in Chaska, MN. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

30-day fills

21 standardized 30-day fills in 2024

CMS converts prescriptions to 30-day supplies so they can be compared. A 90-day prescription counts as about three 30-day fills.

What this does not show: 30-day fills

It is not a count of patients and not a measure of quality.

Part D drug cost

$73 in 2024

The total cost of these prescriptions in 2024, paid by Medicare drug plans, patients and other payers together.

What this does not show: Part D drug cost

A higher cost often reflects the type of medicines a specialty uses. It is not your out-of-pocket cost and not a measure of quality.

Source: CMS, Medicare Part D Prescribers – by Provider and Drug, 2024.

Open Payments general payments, program year 2025

All general payments: $326.20 across 4 records.

By nature of payment

  • Food and Beverage: $192.50 across 2 records.
  • Education: $125.00 across 1 record.
  • Gift: $8.70 across 1 record.

Reporting-company totals

  • Align Technology, Inc.: $326.20 across 4 records.

A reported payment does not necessarily mean the financial relationship is improper and is not a measure of care quality. Clinicians can review and dispute these records.

See the full table

Source: Calculated by T-MedInfo from CMS Open Payments general-payment records for program year 2025 (published June 30, 2026).

Guide: How to read an Open Payments record

NPI first issued

2018

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Mound and Minnesota

Billing and prescribing volume is not a quality rating.

Medicare Part D prescriptions

Fewer Part D prescriptions than 60% of clinicians listed under Dentist in Minnesota (2024, 752 clinicians with data). Median for this group: 30. Middle half: 17 to 54.

Too few clinicians listed under Dentist in Mound have Medicare Part D data for 2024 to compare.

Part D drug cost

A lower Part D drug cost than 65% of clinicians listed under Dentist in Minnesota (2024, 752 clinicians with data). Median for this group: $108. Middle half: $58 to $216.

Too few clinicians listed under Dentist in Mound have Medicare Part D data for 2024 to compare.

3 active clinicians are listed under Dentist with a practice address in Mound, MN (1,796 in Minnesota).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Medicare Part D Prescribers (2024), CMS Open Payments (2025), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo · Report an error.

Pharma & Medical Device Financial Disclosures

Payments and other transfers of value that drug and medical device companies reported to CMS Open Payments

Open Payments · Program Year 2025
Disclosure Year:

Program year 2025 (payments made January 1 – December 31, 2025): fewer than 11 records totaling $326.20.

Manufacturer Payment Nature Product Type Amount ($)
Align Technology, Inc.
Education
Cash or cash equivalent
Invisalign General $125.00
Align Technology, Inc.
Food and Beverage
Cash or cash equivalent
Invisalign General $121.11
Align Technology, Inc.
Food and Beverage
Cash or cash equivalent
Invisalign General $71.39
Align Technology, Inc.
Gift
Cash or cash equivalent
Invisalign General $8.70

Source: CMS Open Payments, program year 2025, released June 30, 2026.

Medicare Part D Prescribing Profile & Medications

Medicare Part D prescriptions filled, including refills, in 2024.

CMS Part D · Data Year 2024
Prescription Year:
Brand Name Generic Name Prescriptions Day Supply Total Cost Patients
Amoxicillin Amoxicillin 21 106 $72.53 17

Source: CMS Part D by Provider and Drug, 2024; rows below 11 claims omitted by CMS; volume isn’t quality. Privacy limits

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2025-04-10
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

License # reported to NPPES MN D14010

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Minnesota Board of Medical Practice.
Look Up on State Board Site

Secondary Practice Locations

132 Pioneer Trl

Chaska, MN 553181167

Phone: 9529004354

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

2 listed
NPI 1457424103

Doctor of Dental Surgery

NPI 1386717049

Doctor of Dental Surgery

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

13 Historical Events
📍
Updated Practice Location April 10, 2025

Registered at 5205 SHORELINE DR, MOUND, MN 553641770 (Tel: 9528312800)

📍
Updated Business Mailing Address April 10, 2025

Registered at 5205 SHORELINE DR, MOUND, MN 553641770 (Tel: 9522606770)

👤
Provider Name / Credentials Updated April 10, 2025

Recorded as KELLY MOORE, DDS

📍
Updated Practice Location June 15, 2022

Registered at 7373 FRANCE AVE S STE 500, EDINA, MN 554354551 (Tel: 9528312800)

📍
Updated Business Mailing Address June 15, 2022

Registered at 7373 FRANCE AVE S STE 500, EDINA, MN 554354551 (Tel: 9528312800)

📍
Updated Practice Location October 14, 2019

Registered at 14475 FOREST BLVD N, HUGO, MN 550387461 (Tel: 6514268088)

📍
Updated Business Mailing Address October 14, 2019

Registered at 14475 FOREST BLVD N, HUGO, MN 550387461 (Tel: 6514268088)

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NPI Profile Active June 11, 2018

NPI status registered as active in NPPES database

📍
Practice Location (Initial Record) June 11, 2018

Registered at 1 VETERANS DR # 2U-122, MINNEAPOLIS, MN 55417 (Tel: 6124672039)

📍
Business Mailing Address (Initial Record) June 11, 2018

Registered at 1 VETERANS DR RM 2U-122, MINNEAPOLIS, MN 554172309 (Tel: 6124672039)

👤
Provider Name / Credentials (Initial Record) June 11, 2018

Recorded as KELLY DJERF, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 11, 2018

Dentist (license number reported to NPPES: MN D14010)

🟢
Initial NPI Registration & Enumeration May 30, 2018

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1790277416
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 30, 2018
Last Update: April 10, 2025
Sole Proprietor: No

Mailing Address

5205 Shoreline Dr

Mound, MN 553641770

Phone: 9522606770

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.