Individual provider Active NPI

Antonio Yuway, D.D.S.

  • General Practice Dentistry
  • St Petersburg, FL
National Provider Identifier
1659583078
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN 12577 Issued in FL
Practice address
6201 Dr Martin Luther King Jr St S
St Petersburg, FL 33705-5608
Phone
(727) 867-7991
Fax
(727) 867-1271
NPI assigned
May 6, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

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 DN 12577 FL Primary

Addresses

Primary practice location

6201 Dr Martin Luther King Jr St S
St Petersburg, FL 33705-5608

Mailing address

6201 Dr Martin Luther King Jr St S
St Petersburg, FL 33705-5608
Phone (727) 867-7991

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20160425002067 FL Order and Referring Only - DentistPractitioner - Dentist 2567761638

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN 12577FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1178409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659583078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 DR MARTIN LUTHER KING JR ST S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337055608",
            "telephone_number": "727-867-7991",
            "fax_number": "727-867-1271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 DR MARTIN LUTHER KING JR ST S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337055608",
            "telephone_number": "727-867-7991",
            "fax_number": "727-867-1271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUWAY",
        "first_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 12577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.