Corie Ann Vitkovic, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

60035282 Issued in WA

Practice address

1417 Lakeside CT
Yakima, WA 98902-7354

Phone

(509) 494-0121

Fax

(509) 494-0171

NPI assigned

Sep 10, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective May 9, 2016 through May 9, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Karen J Tritinger-Young DMD PLLC

  dba Lakeside Dentistry

  • General Practice Dentistry
  • Yakima, WA
  • NPI 1588136766
  NPD (past)
• Steven T. Kitts DDS PLLC

  • Dentist
  • Yakima, WA
  • NPI 1598118069
  NPD (past)

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

{
    "created_epoch": "1221004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221004800000",
    "number": "1669621983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 LAKESIDE CT",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989027354",
            "telephone_number": "509-494-0121",
            "fax_number": "509-494-0171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 LAKESIDE CT",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989027354",
            "telephone_number": "509-494-0121",
            "fax_number": "509-494-0171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITKOVIC",
        "first_name": "CORIE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-10",
        "last_updated": "2008-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "60035282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Giselle Villanueva, PHARMD
• Vanessa Violeta
• Josephine Virgen, CM 60705971
• Mariah E Visco, AAC CG61589288
• Vision for Independence Center
• Vivek Shah MD PLLC (28th Ave Medical)
• Thu Huong Thi Vo, PHARM.D
• Dane Aaron Voelker, PT, DPT
• Brandy Deanne Voight, DPH
• Sarah Voline, ARNP

• General Practice Dentistry in Yakima, WA
• Providers in Yakima, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.