Individual provider Active NPI

Birch Arthur Yuknis, DDS

  • Dentist
  • Wasilla, AK
National Provider Identifier
1750308599
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
992 Issued in AK
Practice address
1700 Bogard Rd
BLDG a Ste 202
Wasilla, AK 99654-6533
Phone
(907) 376-9591
Fax
(907) 357-6345
NPI assigned
Jul 17, 2006
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
Dentist 122300000X 992 AK Primary

Addresses

Primary practice location

1700 Bogard Rd
BLDG a Ste 202
Wasilla, AK 99654-6533

Mailing address

1700 Bogard Rd
BLDG a Ste 202
Wasilla, AK 99654-6533
Phone (907) 376-9591

Other identifiers 2

IdentifierTypeStateIssuer
917825OtherAKTRICARE
DD09921MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
992AKMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750308599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 BOGARD RD",
            "address_2": "BLDG A STE 202",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996546533",
            "telephone_number": "907-376-9591",
            "fax_number": "907-357-6345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 BOGARD RD",
            "address_2": "BLDG A STE 202",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996546533",
            "telephone_number": "907-376-9591",
            "fax_number": "907-357-6345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUKNIS",
        "first_name": "BIRCH",
        "middle_name": "ARTHUR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AK",
            "license": "992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "917825",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DD09921",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.