NPIMap

Organization Active NPI

Michael T McHugh D.D.S., PA

  • Dental Clinic/Center
  • Pocatello, ID
National Provider Identifier
1891918603
Registry record updated Sep 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
D1755 Issued in ID
Legal business name
MICHAEL T MCHUGH D.D.S., PA
Practice address
1246 Yellowstone Ave
Ste. D3
Pocatello, ID 83201-4374
Phone
(208) 238-0125
Fax
(208) 478-2200
NPI assigned
Apr 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2007

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

Authorized official

Name
Dr. Michael T McHugh, D.D.S.NPI 1326356122
Title
President
Phone
(208) 238-0125

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X D1755 ID Primary

Addresses

Primary practice location

1246 Yellowstone Ave
Ste. D3
Pocatello, ID 83201-4374

Mailing address

1246 Yellowstone Ave
Ste. D3
Pocatello, ID 83201-4374
Phone (208) 238-0125

Other identifiers 4

IdentifierTypeStateIssuer
679416OtherUNITED CONCORDIA
68007OtherIDBLUE CROSS OF IDAHO
123544OtherDESERET MUTUAL
000010009646OtherIDBLUE SHIELD OF IDAHO

National Provider Directory

National Provider Directory

Locations

1246 Yellowstone Ave
Ste D3
Pocatello, ID 83201
Phone (208) 238-0125

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189123200000",
    "number": "1891918603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1246 YELLOWSTONE AVE",
            "address_2": "STE. D3",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014374",
            "telephone_number": "208-238-0125",
            "fax_number": "208-478-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1246 YELLOWSTONE AVE",
            "address_2": "STE. D3",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014374",
            "telephone_number": "208-238-0125",
            "fax_number": "208-478-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL T MCHUGH D.D.S., PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-09-07",
        "status": "A",
        "authorized_official_last_name": "MCHUGH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-238-0125",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "ID",
            "license": "D1755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "679416",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "68007",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DESERET MUTUAL",
            "identifier": "123544",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF IDAHO",
            "identifier": "000010009646",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2007; 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.