Provider Demographics
NPI:1104380443
Name:YUKI DYKES DDS PC
Entity Type:Organization
Organization Name:YUKI DYKES DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YUKI
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:DYKES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-690-0800
Mailing Address - Street 1:6240 S MAIN ST., STE 275
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016
Mailing Address - Country:US
Mailing Address - Phone:303-690-0800
Mailing Address - Fax:303-690-2097
Practice Address - Street 1:6240 S MAIN ST., STE 275
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016
Practice Address - Country:US
Practice Address - Phone:303-690-0800
Practice Address - Fax:303-690-2097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-30
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO21727210Medicaid