Yuliya Petukhova, MD, DDS in Salt Lake City, UT

Yuliya Petukhova, MD, DDS is a medicare enrolled "Dentist - Oral And Maxillofacial Surgery" provider in Salt Lake City, Utah. Her current practice location is 1377 E 3900 S Ste 104, Salt Lake City, Utah. You can reach out to her office (for appointments etc.) via phone at (801) 277-3942.

Yuliya Petukhova is licensed to practice in Utah (license number 12048924-9926) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1285253112.

Contact Information

	Yuliya Petukhova, MD, DDS
	1377 E 3900 S Ste 104, Salt Lake City, UT 84124-1492
	(801) 277-3942
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Yuliya Petukhova
Gender	Female
Speciality	Dentist - Oral And Maxillofacial Surgery
Location	1377 E 3900 S Ste 104, Salt Lake City, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1285253112
Provider Enumeration Date: 04/10/2020
Last Update Date: 07/08/2026

Medicare PECOS Information:

PECOS PAC ID: 4981028453
Enrollment ID: I20200717000293

Medical Identifiers

Medical identifiers for Yuliya Petukhova such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1285253112	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1223S0112X	Dentist - Oral And Maxillofacial Surgery	D14456 (Minnesota)	Secondary
1223S0112X	Dentist - Oral And Maxillofacial Surgery	12048924-9926 (Utah)	Primary
122300000X	Dentist	D14456 (Minnesota)	Secondary
204E00000X	Oral & Maxillofacial Surgery	77495 (Minnesota)	Secondary
1223S0112X	Dentist - Oral And Maxillofacial Surgery	77495 (Minnesota)	Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Yuliya Petukhova allows following entities to bill medicare on her behalf.

Entity Name	Mayo Clinic
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1922074434 PECOS PAC ID: 6507778255 Enrollment ID: O20031103000285

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Yuliya Petukhova is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Yuliya Petukhova, MD, DDS 1377 E 3900 S Ste 104, Salt Lake City, UT 84124-1492 Ph: (801) 277-3942	Yuliya Petukhova, MD, DDS 1377 E 3900 S Ste 104, Salt Lake City, UT 84124-1492 Ph: (801) 277-3942

Reviews and Comments

Dentist in Salt Lake City, UT

Dr. Adam Richard Van Leeuwen, D.D.S. Dentist Medicare: Medicare Enrolled Practice Location: 6936 South 2475 East, 201, Salt Lake City, UT 84121 Phone: 801-943-1612 Fax: 801-942-6008
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Victor O Pickett, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 5255 S 4015 W, Suite 180, Salt Lake City, UT 84118 Phone: 801-968-9003
Kelly D Carroll, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 2114 Fort Union Blvd, Salt Lake City, UT 84121 Phone: 801-943-2020
Dr. Oscar Daniel Bluth, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 515 S 1000 E, Suite L-2 West, Salt Lake City, UT 84102 Phone: 801-370-0050
Dr. Michael Reed Slater, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 500 Foothill Blvd, Salt Lake City, UT 84148 Phone: 801-584-1206
Reid Alexander Frye, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 590 Foothill Blvd, Salt Lake City, UT 84113 Phone: 801-584-1206

Yuliya Petukhova, MD, DDS - Medicare Dentist in Salt Lake City, UT