Provider Demographics
NPI:1144379868
Name:YEPKO, HUBERT J (DDS)
Entity Type:Individual
Prefix:
First Name:HUBERT
Middle Name:J
Last Name:YEPKO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 BIG EAGLE RD
Mailing Address - Street 2:
Mailing Address - City:ATKINSON
Mailing Address - State:NC
Mailing Address - Zip Code:28421-9382
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:162 BIG EAGLE RD
Practice Address - Street 2:
Practice Address - City:ATKINSON
Practice Address - State:NC
Practice Address - Zip Code:28421-9382
Practice Address - Country:US
Practice Address - Phone:910-283-0449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5685122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8999653Medicaid