NPIMap

Organization Active NPI

Night Boat PLLC

  • Pediatric Dentistry
  • Rexburg, ID
National Provider Identifier
1013188804
Registry record updated Feb 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
NIGHT BOAT PLLC
Doing business as
Madison Pediatric Dentistry
Practice address
859 S Yellowstone Hwy Ste 1202
Rexburg, ID 83440-6201
Phone
(208) 552-5439
Fax
(208) 552-5440
NPI assigned
Mar 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Ross N Hugues, D.D.S.
Title
Owner/Pediatric Dentist
Phone
(208) 552-5439

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

859 S Yellowstone Hwy Ste 1202
Rexburg, ID 83440-6201

Mailing address

859 S Yellowstone Hwy Ste 1202
Rexburg, ID 83440-6201
Phone (208) 552-5439

Other identifiers 4

IdentifierTypeStateIssuer
807793700MedicaidID
6P475OtherIDBLUECROSS OF IDAHO
9202516OtherMEDICAID - IDAHO SMILES
000010165079OtherIDREGENCE BLUESHIELD OF ID

Other names 1

  • Madison Pediatric Dentistry Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455235200000",
    "number": "1013188804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "859 S YELLOWSTONE HWY STE 1202",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834406201",
            "telephone_number": "208-552-5439",
            "fax_number": "208-552-5440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "859 S YELLOWSTONE HWY STE 1202",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834406201",
            "telephone_number": "208-552-5439",
            "fax_number": "208-552-5440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIGHT BOAT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-19",
        "last_updated": "2016-02-12",
        "status": "A",
        "authorized_official_last_name": "HUGUES",
        "authorized_official_first_name": "ROSS",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER/PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "208-552-5439",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807793700",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS OF IDAHO",
            "identifier": "6P475",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID - IDAHO SMILES",
            "identifier": "9202516",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUESHIELD OF ID",
            "identifier": "000010165079",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Madison Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rexburg, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.