Active NPI
Dwight Laughton Youngman, DDS
- General Practice Dentistry
- Bethany, MO
National Provider Identifier
1023097482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D012121
- Practice address
- 3305 Miller St
Bethany, MO 64424-2716 - Phone
- (660) 425-3616
- NPI assigned
- Jan 13, 2006
- Last updated
- Jul 13, 2026
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D012121 | MO | Primary |
Addresses
Primary practice location
3305 Miller St
Bethany, MO 64424-2716
Mailing address
PO Box 128
3305 Miller Street
Bethany, MO 64424-0128
Phone (660) 425-3616
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160113000548 | MO | Order and Referring Only - Dentist | 8426350026 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D012121 | MO | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1023097482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 128",
"address_2": "3305 MILLER STREET",
"city": "BETHANY",
"state": "MO",
"postal_code": "644240128",
"telephone_number": "660-425-3616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3305 MILLER ST",
"city": "BETHANY",
"state": "MO",
"postal_code": "644242716",
"telephone_number": "660-425-3616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNGMAN",
"first_name": "DWIGHT",
"middle_name": "LAUGHTON",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-13",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MO",
"license": "D012121",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bethany, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.