Larue Antoine Bluth, D.M.D.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

D4267 Issued in ID

Practice address

5244 N Eagle Rd
Boise, ID 83713-0945

Phone

(208) 890-4980

NPI assigned

Apr 18, 2007

Last updated

Nov 9, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257724800000",
    "number": "1396961157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5244 N EAGLE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837130945",
            "telephone_number": "208-890-4980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5244 N EAGLE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837130945",
            "telephone_number": "208-890-4980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUTH",
        "first_name": "LARUE",
        "middle_name": "ANTOINE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2009-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "46364",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "ID",
            "license": "D4267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blue Skies Behavioral Health
• Aaron Blue, MD, MSC
• Sky R Blue, M.D.
• Jerilynn Blum, LCPC
• Mitchell Eric Blume, PA-C, RD, CDE
• Desiree Ann Blythe, LPC, MS, NCC
• Kerriann Boanca, MD
• Rd Boardman, LPC
• Jill Elizabeth Boatman, NP
• Renee A Bobrowski, MD

• Endodontics in Boise, ID
• Providers in Boise, ID by specialty
• Endodontics in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2009; 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.