LIGHTHOUSE DENTAL GROUP NPI 1174631287

NPI Information

  • NPI: 1174631287
  • Provider Name: LIGHTHOUSE DENTAL GROUP
  • Classification: Dentist - 122300000X
  • Entity Type: Organization
  • Address: 1177 N EAGLE RD
    EAGLE, ID
    ZIP 83616
  • Phone: (208) 939-3010

Map and Directions

Get Directions

NPI Details

LIGHTHOUSE DENTAL GROUP is a dentist in Eagle, ID. The provider is a dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. LIGHTHOUSE DENTAL GROUP NPI is 1174631287. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1177 N EAGLE RD
EAGLE, ID
ZIP 83616
Phone: (208) 939-3010
Fax: (208) 939-3027

The provider's authorized official is Michael Lynn Higginson .
The authorized official title is Partner/dentist and has the following contact phone number (208) 939-3010.

The enumeration date for this NPI number is 8/28/2006 and was last updated on 1/12/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1122300000XDentistDRUG ID #BH6399857IDAHONo
2122300000XDentistD3878IDAHONo
3122300000XDentistDRUG ID #BJ9304623IDAHONo
4122300000XDentistD3380IDAHOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1450530374MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.