Individual provider Active NPI

David C Ukena, DDS

  • General Practice Dentistry
  • Springfield, MO
National Provider Identifier
1538178165
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
015049 Issued in MO
Practice address
3259 E Sunshine St
Suite K
Springfield, MO 65804-6919
Phone
(417) 887-5925
Fax
(417) 887-5998
NPI assigned
Aug 5, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 015049 MO Primary

Addresses

Primary practice location

3259 E Sunshine St
Suite K
Springfield, MO 65804-6919

Mailing address

3259 E Sunshine St
Suite K
Springfield, MO 65804-6919
Phone (417) 887-5925

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20150605002377 MO Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3870814551

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
015049MOMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1538178165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3259 E SUNSHINE ST",
            "address_2": "SUITE K",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658046919",
            "telephone_number": "417-887-5925",
            "fax_number": "417-887-5998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3259 E SUNSHINE ST",
            "address_2": "SUITE K",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658046919",
            "telephone_number": "417-887-5925",
            "fax_number": "417-887-5998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UKENA",
        "first_name": "DAVID",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "015049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.