Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Stacy J. Moon DDS, PA

Organization Dental Clinic/Center · NPI 1851554737

Stacy J. Moon DDS, PA is a Dental Clinic/Center in Boise, Idaho. Licensed in Idaho. Registered with an NPI since 2008.

Licensed in
ID
In the registry since
2008
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

6019 N Eagle Rd
Boise, ID 83713-0997
Phone: (208) 939-7053
Fax: (208) 938-6032
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dental Clinic/Center (primary) Taxonomy 261QD0000X · Licence D3387 (ID)

Record details

NPI number1851554737
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Stacy Moon — President · (208) 939-7053
NPI enumeratedJuly 9, 2008
Last updated in NPPESJuly 9, 2008
Mailing address6019 N Eagle Rd, Boise, ID 83713-0997

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