Individual provider Active NPI

Yuchun Zhang, D.D.S

  • Dentist
  • Defiance, OH
National Provider Identifier
1194278820
Registry record updated Jun 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30.24880 Issued in OH
Practice address
1601 N Clinton St
Defiance, OH 43512-8551
Phone
(781) 366-5004
NPI assigned
Jul 29, 2016
Last updated
Jun 30, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30.24880 OH Primary

Addresses

Primary practice location

1601 N Clinton St
Defiance, OH 43512-8551

Mailing address

1601 N Clinton St
Defiance, OH 43512-8551
Phone (781) 366-5004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161011003266 OH Order and Referring Only - DentistPractitioner - Dentist 0345538179

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30.24880OHMDDentist

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1469750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1194278820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 N CLINTON ST",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435128551",
            "telephone_number": "781-366-5004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 N CLINTON ST",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435128551",
            "telephone_number": "781-366-5004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZHANG",
        "first_name": "YUCHUN",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-29",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.24880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Defiance, OH

Sources for this page

Verify at the official NPI Registry.