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CLUBHOUSE PEDIATRIC DENTISTRY OF MADISON
NPI 1306321351
Dentist - Pediatric Dentistry in Rexburg, ID

Active since September 26, 2018
859 S YELLOWSTONE HWY, REXBURG, ID 83440(208) 552-5439 Get Directions Write a Review

NPPES record last updated: September 26, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Clubhouse Pediatric Dentistry Of Madison NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CLUBHOUSE PEDIATRIC DENTISTRY OF MADISON (NPI 1306321351) is a healthcare organization registered as a pediatric dentistry in Rexburg, Idaho and active in the NPI registry since September 2018. The organization lists Jennifer Louise Robison, Financial Coordinator, as its authorized official.

NPPES Registry Identity

NPI1306321351
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NameCLUBHOUSE PEDIATRIC DENTISTRY OF MADISON
Location Address859 S YELLOWSTONE HWYRexburg, ID 83440-5293
Mailing Address859 S Yellowstone HwyRexburg, ID 83440-5293 · (208) 552-5439
Phone(208) 552-5439
Organization SubpartNo
Authorized OfficialJennifer Louise RobisonFinancial Coordinator · (208) 520-1514
Enumeration DateSeptember 26, 2018
✔ NPI 1306321351 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
859 S YELLOWSTONE HWY, Rexburg, ID 83440
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Other Identifiers 1

Medicaid28954ID

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RACHEL BATEMON
Speech-Language Pathologist
859 S YELLOWSTONE HWY, SUITE 1701
REXBURG, ID 83440
Madison County (208) 356-7643
AMANDA WHITE
Behavior Technician
859 S YELLOWSTONE HWY
REXBURG, ID 83440
Madison County (307) 257-5487
DR. SPENCER E. MAUSETH D.D.S.
Dentist (Pediatric Dentistry)
859 S YELLOWSTONE HWY, SUITE #1202
REXBURG, ID 83440
Madison County (208) 552-5439
BRIANNE R BANKS SLP
Speech-Language Pathologist
859 S YELLOWSTONE HWY
REXBURG, ID 83440
Madison County (208) 356-7643
HGNS INVESTMENTS
Prosthetic/Orthotic Supplier
859 S YELLOWSTONE HWY, SUITE 101
REXBURG, ID 83440
Madison County (208) 522-6433
JEFFREY KENNETH DESPOT MS CF-SLP
Speech-Language Pathologist
859 S YELLOWSTONE HWY
REXBURG, ID 83440
Madison County (208) 356-7643
LAURA DOLEZAL CCC/SLP
Speech-Language Pathologist
859 S YELLOWSTONE HWY, SUITE 1702
REXBURG, ID 83440
Madison County (208) 351-5791
MS. SARAH PANTING M.S., CCC-SLP
Speech-Language Pathologist
859 S YELLOWSTONE HWY, SUITE 1701
REXBURG, ID 83440
Madison County (208) 351-3695

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Clubhouse Pediatric Dentistry Of Madison's NPI number?

The NPI number for Clubhouse Pediatric Dentistry Of Madison is 1306321351. It was assigned to this organization in the NPPES registry on September 26, 2018.

Where is Clubhouse Pediatric Dentistry Of Madison located?

Clubhouse Pediatric Dentistry Of Madison is located at 859 S Yellowstone Hwy, Rexburg, ID 83440. The listed phone number is (208) 552-5439.

What is Clubhouse Pediatric Dentistry Of Madison's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

What insurance does Clubhouse Pediatric Dentistry Of Madison accept?

Health plans from UnitedHealthcare list Clubhouse Pediatric Dentistry Of Madison as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Clubhouse Pediatric Dentistry Of Madison was last updated on September 26, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.