NPIMap

Organization Active NPI

Young Dental, LTD

  • Dental Clinic/Center
  • Mokena, IL
National Provider Identifier
1013440825
Registry record updated Apr 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
019029534 Issued in IL
Legal business name
YOUNG DENTAL, LTD
Practice address
18700 Wolf Rd
Ste 200
Mokena, IL 60448-8456
Phone
(954) 536-4810
NPI assigned
Apr 7, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Eric Alberto Young, DDSNPI 1508208661
Title
Dentist
Phone
(954) 536-4810

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 019029534 IL Primary

Addresses

Primary practice location

18700 Wolf Rd
Ste 200
Mokena, IL 60448-8456

Mailing address

18700 Wolf Rd
Ste 200
Mokena, IL 60448-8456

Other names 1

  • Mill Pond Dental Group Doing business as

National Provider Directory

National Provider Directory

Locations

18700 Wolf Rd
Ste 200
Mokena, IL 60448
Phone (708) 478-8866

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1491523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491523200000",
    "number": "1013440825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18700 WOLF RD",
            "address_2": "STE 200",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604488456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18700 WOLF RD",
            "address_2": "STE 200",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604488456",
            "telephone_number": "954-536-4810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUNG DENTAL, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-07",
        "last_updated": "2017-04-07",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "ALBERTO",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "954-536-4810",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "019029534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mill Pond Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mokena, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.

Verify at the official NPI Registry.