NPIMap

Organization Active NPI

Yah Ortho Inc

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Pueblo, CO
National Provider Identifier
1114316627
Registry record updated Feb 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
8809 Issued in CO
Legal business name
YAH ORTHO INC
Practice address
3821 W Pueblo Blvd
Pueblo, CO 81005-2713
Phone
(197) 564-6467
NPI assigned
Jan 21, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2021

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

Authorized official

Name
Pawel R Bielecki, DDS
Title
Owner
Phone
(720) 435-1550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 8809 CO Primary

Addresses

Primary practice location

3821 W Pueblo Blvd
Pueblo, CO 81005-2713

Mailing address

2603 Vinewood LN
Pueblo, CO 81005-3370
Phone (719) 564-6464

Other identifiers 1

IdentifierTypeStateIssuer
31571336MedicaidCO

National Provider Directory

National Provider Directory
Tax ID family
Yah Ortho Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 3

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1421798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613520000000",
    "number": "1114316627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2603 VINEWOOD LN",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810053370",
            "telephone_number": "719-564-6464",
            "fax_number": "719-564-1888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3821 W PUEBLO BLVD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810052713",
            "telephone_number": "197-564-6467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YAH ORTHO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-21",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A",
        "authorized_official_last_name": "BIELECKI",
        "authorized_official_first_name": "PAWEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-435-1550",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CO",
            "license": "8809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31571336",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; 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.