Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. STACY JERALD MOON, DDS
Active Sole ProprietorMR. STACY JERALD MOON, DDS is a Dentist healthcare provider located in BOISE, Idaho. NPI 1881645166 is currently active in the NPPES registry. Verify at CMS.
Dentist · BOISE, ID
Registration Details
- NPI Number
- 1881645166
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 12, 2006 (20.231903970619 yrs)
- Last Updated
- Jul 6, 2023
- License
-
D3387 (ID)
- Sole Proprietor
- Yes
Practice Information
- Address
-
4266 N EAGLE RDBOISE, ID, 837130726Browse ID providers · Browse ZIP 83713
- Phone
- 2089397053
- Fax
- 2089386032
- Primary Specialty
-
Dentist
122300000X
Other Dentist Providers in BOISE, ID
| Name | Credential | NPI |
|---|---|---|
| DR. A RILEY CUTLER | DDS | 1457354466 |
| THOMAS R CURTIS | DDS | 1831199447 |
| BRIAN BIRD | DMD | 1316931819 |
| DR. RIKI RYAN LAMBERT | DDS | 1164412706 |
| DR. TIMOTHY A HANSEN | DDS | 1215911920 |
| MR. TAYLOR COLEMAN CLARK | DDS | 1780635037 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.