NPIMap

Organization Active NPI

John M Ukich

  • Pediatric Dentistry
  • Sandpoint, ID
National Provider Identifier
1720259484
Registry record updated Mar 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
D1656 Issued in ID
Legal business name
JOHN M UKICH
Doing business as
Pediatric Dental Center of North Idaho
Practice address
1310 Ponderosa Dr
Suite B
Sandpoint, ID 83864-5073
Phone
(208) 255-5410
Fax
(208) 255-5420
NPI assigned
Mar 20, 2008
Organization subpart
Yes
Parent organization
JOHN M UKICH, DDS, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 20, 2008

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

Authorized official

Name
John M Ukich
Title
President
Phone
(208) 667-3556

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X D1656 ID Primary

Addresses

Primary practice location

1310 Ponderosa Dr
Suite B
Sandpoint, ID 83864-5073

Mailing address

1310 Ponderosa Dr
Suite B
Sandpoint, ID 83864-5073
Phone (208) 255-5410

Other names 1

  • Pediatric Dental Center of North Idaho Doing business as

National Provider Directory

National Provider Directory
Tax ID family
John M Ukich Ddspa2 organizations share this tax ID, including this one
Part of
John M Ukich Ddspa

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1310 Ponderosa Dr
Ste B
Sandpoint, ID 83864
Phone (208) 255-5410

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1205971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205971200000",
    "number": "1720259484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 PONDEROSA DR",
            "address_2": "SUITE B",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838645073",
            "telephone_number": "208-255-5410",
            "fax_number": "208-255-5420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 PONDEROSA DR",
            "address_2": "SUITE B",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838645073",
            "telephone_number": "208-255-5410",
            "fax_number": "208-255-5420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN M UKICH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JOHN M UKICH, DDS, PA",
        "enumeration_date": "2008-03-20",
        "last_updated": "2008-03-20",
        "status": "A",
        "authorized_official_last_name": "UKICH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-667-3556"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "ID",
            "license": "D1656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Dental Center of North Idaho",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sandpoint, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.