Active NPI
Jeffrey Youngberg
- Dentist
- Vacaville, CA
National Provider Identifier
1003292608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 64725
- Practice address
- 770 Mason St
Suite 110
Vacaville, CA 95688-4646 - Phone
- (707) 447-1010
- NPI assigned
- Aug 5, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 64725 | CA | Primary |
Addresses
Primary practice location
770 Mason St
Suite 110
Vacaville, CA 95688-4646
Mailing address
770 Mason St
Suite 110
Vacaville, CA 95688-4646
Phone (707) 447-1010
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Valley Dental | Dentist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dentist
- Vacaville, CA
- NPI 1730631086
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489622400000",
"number": "1003292608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "770 MASON ST",
"address_2": "SUITE 110",
"city": "VACAVILLE",
"state": "CA",
"postal_code": "956884646",
"telephone_number": "707-447-1010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "770 MASON ST",
"address_2": "SUITE 110",
"city": "VACAVILLE",
"state": "CA",
"postal_code": "956884646",
"telephone_number": "707-447-1010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNGBERG",
"first_name": "JEFFREY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-08-05",
"last_updated": "2017-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "64725",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vacaville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.