Barry J Uldrikson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

AZ3119 Issued in AZ

Practice address

1101 Riata Valley Rd.
Kingman, AZ 86409

Phone

(928) 692-9394

Fax

(928) 692-9399

NPI assigned

Nov 30, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1821166760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 RIATA VALLEY RD",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "86409",
            "telephone_number": "928-692-9394",
            "fax_number": "928-692-9399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 RIATA VALLEY RD.",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "86409",
            "telephone_number": "928-692-9394",
            "fax_number": "928-692-9399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULDRIKSON",
        "first_name": "BARRY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "AZ3119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "580937-03",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL",
            "identifier": "D3119",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "AZ0471610",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justina Truong, D.O.
• Panayiota Tsokas, SCHOOL COUNSELOR
• Robert Alan Tucker, PHARM.D.
• Twin Peaks Medical Associates PLLC
• Tyler T Tatton DDS PC
• Uptown Pharmacy of Kingman , Inc
• Uptown Pharmacy of Kingman , Inc
• Uptown Pharmacy of Kingman , Inc
• Uptown Pharmacy of Kingman , Inc
• Nathaniel Urquhart, DMD

• General Practice Dentistry in Kingman, AZ
• Providers in Kingman, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.