Active NPI
Lisa Moore, DH-1002
- Dental Hygienist
- Plummer, ID
National Provider Identifier
1194637249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- DH-1002
- Practice address
- 427 12TH St
Plummer, ID 83851-4000 - Phone
- (208) 686-1931
- NPI assigned
- Sep 22, 2026
- Last updated
- Sep 22, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | DH-1002 | ID | Primary |
Addresses
Primary practice location
427 12TH St
Plummer, ID 83851-4000
Mailing address
427 12TH St
Plummer, ID 83851-4000
Phone (208) 686-1931
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DH-1002 | ID | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790035200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790035200000",
"number": "1194637249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "427 12TH ST",
"city": "PLUMMER",
"state": "ID",
"postal_code": "838514000",
"telephone_number": "208-686-1931"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "427 12TH ST",
"city": "PLUMMER",
"state": "ID",
"postal_code": "838514000",
"telephone_number": "208-686-1931"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "LISA",
"credential": "DH-1002",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-09-22",
"last_updated": "2026-09-22",
"certification_date": "2026-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "ID",
"license": "DH-1002",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plummer, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.