JOHN M UKICH (NPI# 1902950041) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902950041 |
| Entity Type | Individual |
| Full Name | JOHN M UKICH |
| Credential | D.D.S. |
| Practice Address |
1717 Lincoln Way Suite 205 Coeur D Alene ID 83814-2556 |
| Mailing Address |
11493 N Eastshore Dr Hayden Lake ID 83835-9091 |
| Practice Telephone | 2086673556 |
| Practice Fax Number | 2086646814 |
| Mailing Telephone | 2086673556 |
| Mailing Fax Number | 2086646814 |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
D1626 | ID | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | STATE LISENCE # | D1656 | 01 |
| ID | BLU CROSS ID# | 6G660 | 01 |
| ID | BLUE SHIELD ID# | 000010009296 | 01 |
| ID | UNITED CONCORDIA # | 526225 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972657922 | John R Ukich | Dentist | 1717 Lincoln Way, Suite 205, Coeur D Alene, ID 83814-2556 | 2007-01-23 |
| Street Address |
1717 LINCOLN WAY SUITE 205 |
| City | COEUR D ALENE |
| State | ID |
| Zip Code | 83814-2556 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235219361 | Thomas Richard Smart | Dentist | 1717 Lincoln Way, Suite 204, Coeur D Alene, ID 83814-2556 | 2006-10-16 |
| 1235588781 | Thomas Lee Jaeger Dds Pa | Dentist | 1717 Lincoln Way, #203, Coeur D Alene, ID 83814-2556 | 2016-06-06 |
| 1083976146 | Jennifer Keane | Counselor | 1717 Lincoln Way, Suite 101, Coeur D Alene, ID 83814-2556 | 2012-06-13 |
| 1598926867 | Jaeger Curtis Orthodontics | Dentist | 1717 Lincoln Way, Suite 203, Coeur D Alene, ID 83814-2556 | 2008-06-19 |
| 1295906063 | John M Ukich, Dds,pa | Dentist | 1717 Lincoln Way, Suite 205, Coeur D Alene, ID 83814-2556 | 2008-03-19 |
| 1619195310 | Brent Unruh | Dentist | 1717 Lincoln Way, Suite 107, Coeur D Alene, ID 83814-2556 | 2007-04-20 |
| 1972657922 | John R Ukich | Dentist | 1717 Lincoln Way, Suite 205, Coeur D Alene, ID 83814-2556 | 2007-01-23 |
| 1881746048 | Brent R. Unruh, Dmd, Pa | Dentist | 1717 Lincoln Way, Suite 107, Coeur D Alene, ID 83814-2556 | 2007-01-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477162675 | Dehra Mcfaddan | Social Worker | 211 E. Coeur D'alene Ave, 102, Coeur D Alene, ID 83814 | 2020-07-24 |
| 1043838634 | Yendi Labelle | Nurse Practitioner | 1115 N Ironwood Drive, Coeur D'alene, ID 83814 | 2020-07-09 |
| 1295353217 | Cultivation, LLC | Counselor | 211 E. Coeur Dalene Ave. Ste 102, Coeur D'alene, ID 83814 | 2020-07-07 |
| 1306487517 | Northwest Integrated Health, LLP | Clinic/Center | 1250 West N. Northwood Center Ct, Suite B, Coeur D'alene, ID 83814 | 2019-09-30 |
| 1730740465 | Connor Williams | Physical Therapist | 1812 W Lakewood Dr, Ste. 100, Coeur D Alene, ID 83814 | 2019-06-24 |
| 1912480153 | Nadine M Lewis | Social Worker | 211 E. Coeur D'alene Ave., Coeur D'alene, ID 83814 | 2018-09-13 |
| 1992208631 | Orthopedic Surgery and Sports | Orthopaedic Surgery | 1812 N Lakewood Drive, Suite 100, Coeur D'alene, ID 83814 | 2018-03-08 |
| 1346758042 | Heather Marie Johnson | Counselor | 7905 Meadowlark Way, Cda, ID 83814 | 2018-01-16 |
| 1881113413 | Brevity Treatment Services | Counselor | 2201 N. Government Way Ste. L, Coeur D'alene, ID 83814 | 2017-09-14 |
| 1366969628 | Jennifer La Gina Highfield | Massage Therapist | 1104 N Ste B, Coeur D Alene, ID 83814 | 2017-08-28 |
| Find all providers in zip 83814 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295906063 | John M Ukich, Dds,pa | Dentist | 1717 Lincoln Way, Suite 205, Coeur D Alene, ID 83814-2556 | 2008-03-19 |
| 1972657922 | John R Ukich | Dentist | 1717 Lincoln Way, Suite 205, Coeur D Alene, ID 83814-2556 | 2007-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124657010 | Rigby Pediatric Dental Pllc | Dentist | 688 Rigby Lake Circle, Suite 4, Rigby, ID 83442 | 2020-04-03 |
| 1154805786 | Jmj Nampa LLC | Dentist | 914 12th Ave Rd, Nampa, ID 83686 | 2018-09-19 |
| 1932683752 | Ikdo State Street LLC | Dentist | 9209 W State St, Garden City, ID 83714 | 2018-09-18 |
| 1902325749 | Cherry Lane Kids Dentistry | Dentist | 1558 N Crestmont Dr Ste A, Meridian, ID 83642-2194 | 2017-09-13 |
| 1922462142 | Our Town Family Dentistry | Dentist | 39 W Idaho St, Weiser, ID 83672-1943 | 2016-04-13 |
| 1720447097 | Brock Coletti | Dentist | 3235 N Towerbridge Way Ste 200, Meridian, ID 83646-5721 | 2016-02-15 |
| 1154799047 | Smiles 4 Kids Blackfoot Pllc | Dentist | 621 Jensen Grove Dr, Blackfoot, ID 83221-1685 | 2015-09-09 |
| 1982012498 | Dallin J. Dance | Dentist | 1027 W. Prairie Ave., Hayden, ID 83835 | 2014-07-28 |
| 1679812002 | Dentistry for Kids Pllc | Dentist | 625 E Alameda Rd., Pocatello, ID 83201 | 2013-02-05 |
| 1609106012 | Cordell Denton Nebeker | Dentist | 4111 Clocktower Ave., Caldwell, ID 83607 | 2010-01-07 |
| Find all providers with the same taxonomy | ||||
| City | COEUR D ALENE |
| Zip Code | 83814 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.