STACY J. MOON DDS, PA
NPI 1851554737
Clinic/Center - Dental in Boise, ID

Q: What is Stacy J. Moon Dds, PA's NPI number?

The NPI number for Stacy J. Moon Dds, PA is 1851554737. It was assigned to this organization in the NPPES registry on July 9, 2008.

Q: What is Stacy J. Moon Dds, PA's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

Active since July 09, 2008

6019 N EAGLE RD, BOISE, ID 83713(208) 939-7053(208) 938-6032 Get Directions Write a Review

NPPES record last updated: July 9, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Stacy J. Moon Dds, Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STACY J. MOON DDS, PA (NPI 1851554737) is a healthcare organization registered as a dental in Boise, Idaho and active in the NPI registry since July 2008. The organization lists Stacy Jerald Moon, President, as its authorized official.

NPPES Registry Identity

NPI1851554737

Entity TypeOrganization

Primary Taxonomy261QD0000X

Legal Business NameSTACY J. MOON DDS, PA

Location Address6019 N EAGLE RDBoise, ID 83713-0997

Mailing Address6019 N Eagle RdBoise, ID 83713-0997 · (208) 939-7053 · Fax (208) 938-6032

Phone(208) 939-7053

Fax(208) 938-6032

Organization SubpartNo

Authorized OfficialStacy Jerald MoonPresident · (208) 939-7053

Enumeration DateJuly 9, 2008

✔ NPI 1851554737 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities

Taxonomy Code261QD0000X

License✔ Licensed in ID · D3387

6019 N EAGLE RD, Boise, ID 83713

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Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALL ABOUT YOU DENTAL, PC

Clinic/Center (Dental)