Provider Demographics
NPI:1891716130
Name:YUHNKE, JAMES MARTIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MARTIN
Last Name:YUHNKE
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 1:44990 HEYDENREICH RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-1558
Mailing Address - Country:US
Mailing Address - Phone:586-463-2770
Mailing Address - Fax:586-463-2779
Practice Address - Street 1:44990 HEYDENREICH RD
Practice Address - Street 2:SUITE E
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-1558
Practice Address - Country:US
Practice Address - Phone:586-463-2770
Practice Address - Fax:586-463-2779
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI21012120281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4823689Medicaid