Jim W Yu, DDS

Primary specialty

DentistTaxonomy code 122300000X

Practice address

1905 Convenience PL
Suite a
Champaign, IL 61820-8926

Phone

(217) 355-5165

Fax

(217) 355-5189

NPI assigned

Mar 2, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dental Professionals of Illinois, P.C.

  dba Creative Smiles Dental Care

  • General Practice Dentistry
  • Champaign, IL
  • NPI 1114149473
  NPD (past)
• Lifetime Dental Care of Illinois, PC

  dba Montvale Dental Center

  • General Practice Dentistry
  • Springfield, IL
  • NPI 1720200074
  NPD (past)

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851420475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 CONVENIENCE PL",
            "address_2": "SUITE A",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618208926",
            "telephone_number": "217-355-5165",
            "fax_number": "217-355-5189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 CONVENIENCE PL",
            "address_2": "SUITE A",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618208926",
            "telephone_number": "217-355-5165",
            "fax_number": "217-355-5189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YU",
        "first_name": "JIM",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1004780",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Lynn Young, DPT
• Sarah B Young, MD
• Steven W Young, PT, MSPT, CSCS
• William D. Youngerman, M.D.
• Gina Yu, LPC
• Karissa Yu
• Rachel Cooper Yuhas, LCPC
• Sami S. Zabaneh, M.D.
• Abu-Bakar Zafar, M.D.
• Joseph A. Zalar, M.D.

• Dentist in Champaign, IL
• Providers in Champaign, IL by specialty
• Dentist in Illinois

• 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.
• 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.