Individual provider Active NPI

Katherine Yiu, DDS

  • General Practice Dentistry
  • Jacksonville, NC
National Provider Identifier
1386218329
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12861 Issued in NC
Practice address
571 Yopp Rd Ste 308
Jacksonville, NC 28540-3683
Phone
(910) 716-0101
Fax
(910) 294-8874
NPI assigned
May 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12861 NC Primary

Addresses

Primary practice location

571 Yopp Rd Ste 308
Jacksonville, NC 28540-3683

Mailing address

571 Yopp Rd Ste 308
Jacksonville, NC 28540-3683
Phone (910) 716-0101

Other practice location 1

5645 Main St
Flushing, NY 11355-5045
Phone (718) 670-1060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20220923000219 NC Order and Referring Only - DentistPractitioner - Dentist 2365827573

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12861NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lane and Associates Xli DDS PA General Practice CurrentSince Sep 20, 2022 Accepting new patients
Lane and Associates Xliv DDS PA General Practice PastSince Jan 1, 2022 Accepting new patients

Locations

571 Yopp Rd
Ste 308
Jacksonville, NC 28540
Phone (910) 716-0101

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1620950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1386218329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "571 YOPP RD STE 308",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285403683",
            "telephone_number": "910-716-0101",
            "fax_number": "910-294-8874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "571 YOPP RD STE 308",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285403683",
            "telephone_number": "910-716-0101",
            "fax_number": "910-294-8874"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5645 Main St",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113555045",
            "country_code": "US",
            "telephone_number": "718-670-1060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YIU",
        "first_name": "KATHERINE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-14",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "12861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

Verify at the official NPI Registry.