{"npi":"1881645166","type":"NPI-1","status":"active","name":{"display":"Mr. Stacy Moon DDS","other":[],"first":"STACY","last":"MOON","middle":"JERALD","credential":"DDS"},"specialty":{"primary_taxonomy":"122300000X","primary_taxonomy_description":"Dentist","slug":"dentist","schema_org_specialty":null,"all":[{"code":"122300000X","description":"Dentist","primary":true,"state":"ID","license":"D3387"}]},"addresses":[{"purpose":"LOCATION","street_1":"4266 N EAGLE RD","city":"BOISE","state":"ID","postal_code":"837130726","country_code":"US","phone":"2089397053","fax":"2089386032"},{"purpose":"MAILING","street_1":"3550 N BROOKSIDE LN","city":"BOISE","state":"ID","postal_code":"837149705","country_code":"US","phone":"2089081793"}],"license":{"state":"ID","number":"D3387"},"identifiers":[{"type_code":"01","label":"Other","value":"820527796","state":"ID","issuer":"IRS"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20180110002872","type_code":"33-C5","type_desc":"ORDER AND REFERRING ONLY - DENTIST","state":"ID","pac_id":"8224397658"}]},"enumeration_date":"2006-05-12","last_updated":"2023-07-06","_meta":{"source":"NPPES","snapshot_date":"2023-07-06","doc_url":"https://findmynpi.com/api"}}