Active NPI
Michael Gordon Yurth, D.D.S.
- General Practice Dentistry
- Grandview, WA
National Provider Identifier
1972894319
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DEN-10413
- Practice address
- 1000 Wallace Way
Grandview, WA 98930-8805 - Phone
- (509) 882-3444
- NPI assigned
- Apr 20, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DEN-10413 | CO | Primary |
Addresses
Primary practice location
1000 Wallace Way
Grandview, WA 98930-8805
Mailing address
501 Byron Rd
Prosser, WA 99350-9562
Phone (509) 786-1132
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160322000157 | WA | Order and Referring Only - Dentist | 8325345291 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEN-10413 | CO | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405468800000",
"number": "1972894319",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 BYRON RD",
"city": "PROSSER",
"state": "WA",
"postal_code": "993509562",
"telephone_number": "509-786-1132"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 WALLACE WAY",
"city": "GRANDVIEW",
"state": "WA",
"postal_code": "989308805",
"telephone_number": "509-882-3444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YURTH",
"first_name": "MICHAEL",
"middle_name": "GORDON",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-04-20",
"last_updated": "2014-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CO",
"license": "DEN-10413",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grandview, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; 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.