NPI age
17 years
Enumerated 2008-07-09
● Active Type 2 · Organization
Stacy J. Moon Dds, PA
Stacy J. Moon Dds, PA is 1 of 202 clinic/center organizations in Idaho.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Moon
President
Last NPPES update
2008-07-09
Source: monthly bulk 2026-05
How this organization compares
Across 202 active clinic/center providers in Idaho.
NPI age
17 years
↑ 9 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2008 → 2026
2008-07Enumerated in NPPES
2008
2026
Where they practice
Primary practice location
6019 N Eagle Rd
Boise, ID 837130997
Mailing address
6019 N Eagle Rd
Boise, ID 837130997
Authorized official
Stacy Jerald Moon, D.D.S.
President
📞 2089397053
Individual providers at this organization
5 individual providers on file at this primary practice address.
- Taylor Clark, DDS Dentist NPI 1780635037
- Robert French, DMD Dentist NPI 1124035472
- Kip Katseanes, DMD MSD Dentist NPI 1366824484
- Christopher Sprott, DMD Dentist NPI 1841731957
- Kristen Yant Dentist NPI 1760163810
Specialties
-
Clinic/Center PrimaryDefinition to come...
Practice context
Multi-provider organization. 5 individual providers on file at this primary address.
Provyx · Custom healthcare lists
Need all 202 Clinic/Center providers in Idaho?
Get the full list as a CSV with verified work emails, direct phones, and LinkedIn URLs.
Request a quote →How to verify this organization
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.