YETTA G MCCULLOM DDS, MA
NPI 1285884791
Dentist - Periodontics in Chicago, IL

Q: What is Yetta Mccullom's NPI number?

The NPI number for Yetta Mccullom is 1285884791. It was assigned to this individual provider in the NPPES registry on September 22, 2008.

Q: What is Yetta Mccullom's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Q: When was this NPI record last updated?

The NPPES record for Yetta Mccullom was last updated on September 23, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years 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.

Active since September 22, 2008PECOS Enrolled

820 E 87TH ST, STE 201, CHICAGO, IL 60619(773) 488-3738(773) 874-6575 Get Directions Write a Review

NPPES record last updated: September 23, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Yetta G Mccullom Dds, Ma NPPES

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

YETTA G MCCULLOM DDS, MA (NPI 1285884791) is an individual periodontics provider in Chicago, Illinois, licensed in Illinois (021001516) and active in the NPI registry since September 2008. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1285884791

Entity TypeIndividualFemale

Primary Taxonomy1223P0300X

Provider Legal NameYETTA G MCCULLOMCredential: DDS, MA

Location Address820 E 87TH ST, STE 201Chicago, IL 60619-6253

Mailing Address820 E 87th St, Ste 201Chicago, IL 60619-6253 · (773) 488-3738 · Fax (773) 874-6575

Phone(773) 488-3738

Fax(773) 874-6575

Sole ProprietorNo

Enumeration DateSeptember 22, 2008

Last NPPES UpdateSeptember 23, 2008

✔ NPI 1285884791 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers

Taxonomy Code1223P0300X

License✔ Licensed in IL · 021001516

Definition

That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.

820 E 87TH ST, Chicago, IL 60619

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Yetta G Mccullom Dds, Ma 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60619 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

$94.06 typical visit price

range $60.08 – $183.39

Typical copayment $23.51 (range $15.02 – $45.84)

Most-billed visit code 99203

Established Patient

$74.80 typical visit price

range $18.97 – $148.12

Typical copayment $18.70 (range $4.74 – $37.03)

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 4

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

DR. CORNELL MCCULLOM III D.D.S., M.D.

Dentist (Oral and Maxillofacial Surgery)

820 E 87TH ST, STE. 201
CHICAGO, IL 60619

Cook County (773) 488-3738

ROBIN L. FERGUSON DDS PC

Dentist (General Practice)

820 E 87TH ST, SUITE 201
CHICAGO, IL 60619

Cook County (773) 488-9075

ROBIN L FERGUSON DDS

Dentist

820 E 87TH ST, STE 201
CHICAGO, IL 60619

Cook County (773) 488-9075

DRS. MCCULLOM P.C.

Dentist (Periodontics)

820 E 87TH ST, SUITE 201
CHICAGO, IL 60619

Cook County (773) 488-3738

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 Yetta Mccullom's NPI number?

The NPI number for Yetta Mccullom is 1285884791. It was assigned to this individual provider in the NPPES registry on September 22, 2008.

Where is Yetta Mccullom located?

Yetta Mccullom practices at 820 E 87th St Ste 201, Chicago, IL 60619. The listed phone number is (773) 488-3738.

What is Yetta Mccullom's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Is Yetta Mccullom enrolled in Medicare?

Yes. Yetta Mccullom is registered in the Medicare PECOS enrollment system.

What insurance does Yetta Mccullom accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 5 other insurers list Yetta Mccullom 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 Yetta Mccullom was last updated on September 23, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years 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.