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YULIYA PETUKHOVA MD, DDS
NPI 1285253112
Dentist - Oral and Maxillofacial Surgery in Salt Lake City, UT

Active since April 10, 2020PECOS Enrolled
1377 E 3900 S STE 104, SALT LAKE CITY, UT 84124(801) 277-3942 Get Directions Write a Review

NPPES record last updated: July 8, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Jul 8, 2026, Sep 9, 2024, Aug 13, 2024 and 3 more (6 updates tracked since 2020).

About Yuliya Petukhova Md, Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

YULIYA PETUKHOVA MD, DDS (NPI 1285253112) is an individual oral and maxillofacial surgery provider in Salt Lake City, Utah, licensed in Utah (12048924-9926) and active in the NPI registry since April 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1285253112
Entity TypeIndividualFemale
Primary Taxonomy1223S0112X
Provider Legal NameYULIYA PETUKHOVACredential: MD, DDS
Location Address1377 E 3900 S STE 104Salt Lake City, UT 84124-1492
Mailing Address1377 E 3900 S Ste 104Salt Lake City, UT 84124-1492 · (801) 277-3942
Phone(801) 277-3942
Sole ProprietorNo
Enumeration DateApril 10, 2020
Last NPPES UpdateJuly 8, 20266 updates tracked since enumeration
NPPES CertifiedJuly 8, 2026
✔ NPI 1285253112 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
Licenses✔ Licensed in UT · 12048924-9926✔ Licensed in MN · D14456✔ Licensed in MN · 77495
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Also ListedDentistTaxonomy 122300000X · License D14456 (MN)
Also ListedOral & Maxillofacial SurgeryTaxonomy 204E00000X · License 77495 (MN)
1377 E 3900 S STE 104, Salt Lake City, UT 84124
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, EMI Health, Florida Combined Life and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Yuliya Petukhova Md, Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

4

Medicare enrollment records show Yuliya Petukhova reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Dustin J Hopkin DDS, Oral And Maxillofacial Surgery P.C.
0.8 mi
Oral and Maxillofacial Surgery
2180 E 4500 S STE 285
Salt Lake City, UT 84117
  • Reassigned Medicare billing, Utah enrollment
  • 2 clinicians in this Medicare group
NPI 1376827832 (801) 277-3942
University Of Utah Adult Services
4.5 mi
Neurology
175 N MEDICAL DR
Salt Lake City, UT 84132
  • Reassigned Medicare billing, Utah enrollment
  • 2,620 clinicians in this Medicare group
NPI 1578967345 (801) 585-7575
University Of Utah Dental Services
5.6 mi
Dental
530 S WAKARA WAY
Salt Lake City, UT 84108
  • Reassigned Medicare billing, Utah enrollment
  • 20 clinicians in this Medicare group
NPI 1821446279 (801) 587-6453
Mayo Clinic
1,014 mi
Infectious Disease
200 1ST ST SW
Rochester, MN 55905
  • Reassigned Medicare billing, Minnesota enrollment
  • 6,534 clinicians in this Medicare group
NPI 1114343860 (507) 284-2511

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84124 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
Established Patient
$68.01 typical visit price
range $17.23 – $135.20
Typical copayment $17.00 (range $4.30 – $33.80)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRADD K CHRISTENSEN M.D.
Plastic Surgery
1377 E 3900 S STE 104
SALT LAKE CITY, UT 84124
Salt Lake County (801) 272-4249

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Yuliya Petukhova's NPI number?

The NPI number for Yuliya Petukhova is 1285253112. It was assigned to this individual provider in the NPPES registry on April 10, 2020.

Where is Yuliya Petukhova located?

Yuliya Petukhova practices at 1377 E 3900 S Ste 104, Salt Lake City, UT 84124. The listed phone number is (801) 277-3942.

What is Yuliya Petukhova's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Yuliya Petukhova enrolled in Medicare?

Yes. Yuliya Petukhova is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Yuliya Petukhova's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Yuliya Petukhova reassigns Medicare benefits to 4 organizations: Dustin J Hopkin DDS, Oral And Maxillofacial Surgery P.C. (Salt Lake City, UT), University Of Utah Adult Services (Salt Lake City, UT), University Of Utah Dental Services (Salt Lake City, UT) and Mayo Clinic (Rochester, MN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Yuliya Petukhova's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Yuliya Petukhova accept?

Health plans from BridgeSpan Health Company, EMI Health, Florida Combined Life, Guardian and Humana and 9 other insurers list Yuliya Petukhova as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Yuliya Petukhova was last updated on July 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.