Provider Demographics
NPI:1639342199
Name:HUGHES, JAMES P (DDS)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:P
Last Name:HUGHES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:834 FALLS AVE
Mailing Address - Street 2:SUITE 2030B
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-3365
Mailing Address - Country:US
Mailing Address - Phone:208-733-9181
Mailing Address - Fax:208-734-8643
Practice Address - Street 1:834 FALLS AVE
Practice Address - Street 2:SUITE 2030B
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-3365
Practice Address - Country:US
Practice Address - Phone:208-733-9181
Practice Address - Fax:208-734-8643
Is Sole Proprietor?:No
Enumeration Date:2008-04-07
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD1934122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID000101700Medicaid