JULIA JANE ANN VIDYAKIN
NPI 1356070890
Dentist in Cape Girardeau, MO

Q: What is Julia Vidyakin's NPI number?

The NPI number for Julia Vidyakin is 1356070890. It was assigned to this individual provider in the NPPES registry on June 9, 2022.

Q: What is Julia Vidyakin's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for Julia Vidyakin was last updated on October 23, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 June 09, 2022PECOS Enrolled

408 S BROADVIEW ST, CAPE GIRARDEAU, MO 63703(573) 332-0808 Get Directions Write a Review

NPPES record last updated: October 23, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Julia Jane Ann Vidyakin NPPES

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

JULIA JANE ANN VIDYAKIN (NPI 1356070890) is an individual dentist in Cape Girardeau, Missouri, licensed in Missouri (2022020735) and active in the NPI registry since June 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1356070890

Entity TypeIndividualFemale

Primary Taxonomy122300000X

Provider Legal NameJULIA JANE ANN VIDYAKIN

Location Address408 S BROADVIEW STCape Girardeau, MO 63703-5725

Mailing Address408 S Broadview StCape Girardeau, MO 63703-5725 · (573) 332-0808

Phone(573) 332-0808

Sole ProprietorNo

Enumeration DateJune 9, 2022

Last NPPES UpdateOctober 23, 2024

NPPES CertifiedOctober 23, 2024

✔ NPI 1356070890 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in MO · 2022020735

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

408 S BROADVIEW ST, Cape Girardeau, MO 63703

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter Health 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)

Julia Jane Ann Vidyakin 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 Reassignment

Medicare enrollment records show Julia Vidyakin reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Cross Trails Medical Center

Same address

Federally Qualified Health Center (FQHC)

408 S BROADVIEW ST
Cape Girardeau, MO 63703

Reassigned Medicare billing, Missouri enrollment
22 clinicians in this Medicare group

NPI 1356393268 (573) 332-0808

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 63703 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

$81.64 typical visit price

range $52.28 – $161.24

Typical copayment $20.41 (range $13.07 – $40.31)

Most-billed visit code 99203

Established Patient

$65.71 typical visit price

range $16.30 – $131.05

Typical copayment $16.42 (range $4.07 – $32.76)

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 20

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

CHARLENE L MINTON DMD

Dentist