MEDICARE: DR. STACY DAVIS MOORMAN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	OH02350	OH
2	122300000X	Dentist	30.020350	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	803310	OTHER	OH	UNITED CONCORDIA PROVIDER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295735892
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STACY DAVIS MOORMAN DDS

Provider Business Mailing Address
First Line	:	14062 US HIGHWAY 23
Second Line	:	SUITE B
City	:	WAVERLY
State	:	OH
Zip	:	45690-9415
Country	:	US
Telephone Number	:	740-947-1990
Fax Number	:

Provider Business Practice Location Address
First Line	:	14062 US HIGHWAY 23
Second Line	:	SUITE B
City	:	WAVERLY
State	:	OH
Zip	:	45690-9415
Country	:	US
Telephone Number	:	740-947-1990
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	04/20/2023

Similar Medicare Providers

1275129256 — DONNA WORKMAN
Practice Location Address:

14062 US HIGHWAY 23
WAVERLY, OH
45690-9415

Practice Phone: 800-582-7277
Practice Fax:

1740265081 — DR. DANIEL K MADSEN D.O.
Practice Location Address:

13800 US RT 23 N
WAVERLY, OH
45690

Practice Phone: 740-947-8602
Practice Fax: 740-947-7943

1558346726 — MARK MARQUEZ R.PH.
Practice Location Address:

100 DAWN LN
WAVERLY, OH
45690-9138

Practice Phone: 740-947-6377
Practice Fax:

1528047461 — LISA K. FROST DDS, LLC
Practice Location Address:

100 E 3RD ST
WAVERLY, OH
45690-1401

Practice Phone: 740-947-8200
Practice Fax: 740-947-8210

1265406151 — MOHAMMAD T. ALI M.D.
Practice Location Address:

227 VALLEY VIEW DR
WAVERLY, OH
45690-9135

Practice Phone: 740-947-7726
Practice Fax: 740-947-9354

1093780462 — MRS. DONA HAUNANI SANDERS CNM
Practice Location Address:

227 VALLEY VIEW DR
WAVERLY, OH
45690-9135

Practice Phone: 740-947-7726
Practice Fax: 740-947-9354

Directions to “ DR. STACY DAVIS MOORMAN DDS” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.