Active NPI
Charles Tanner Higham, DMD
- General Practice Dentistry
- Rexburg, ID
National Provider Identifier
1255997888
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D-5023
- Practice address
- 242 E Main St
Rexburg, ID 83440-2022 - Phone
- (208) 206-5566
- NPI assigned
- May 20, 2019
- Sex
- Male
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D-5023 | ID | Primary |
Addresses
Primary practice location
242 E Main St
Rexburg, ID 83440-2022
Mailing address
242 E Main St
Rexburg, ID 83440-2022
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 |
|---|---|---|---|
| D-5023 | ID | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558310400000",
"number": "1255997888",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "242 E MAIN ST",
"city": "REXBURG",
"state": "ID",
"postal_code": "834402022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "242 E MAIN ST",
"city": "REXBURG",
"state": "ID",
"postal_code": "834402022",
"telephone_number": "208-206-5566"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HIGHAM",
"first_name": "CHARLES",
"middle_name": "TANNER",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-05-20",
"last_updated": "2019-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "ID",
"license": "D-5023",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 May 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.