NPIMap

Organization Active NPI

Young Kidz Dental

  • Pediatric Dentistry
  • Clackamas, OR
National Provider Identifier
1023222643
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
D8094 Issued in OR
Legal business name
YOUNG KIDZ DENTAL
Practice address
14210 SE Sunnyside Rd Ste 100
Clackamas, OR 97015-5241
Phone
(503) 658-3384
Fax
(503) 658-1817
NPI assigned
May 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Todd M Young, DDSNPI 1841299377
Title
Owner
Phone
(503) 658-3384

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
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X D8094 OR Primary

Addresses

Primary practice location

14210 SE Sunnyside Rd Ste 100
Clackamas, OR 97015-5241

Mailing address

14210 SE Sunnyside Rd Ste 100
Clackamas, OR 97015-5241
Phone (503) 658-3384

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023222643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14210 SE SUNNYSIDE RD STE 100",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970155241",
            "telephone_number": "503-658-3384",
            "fax_number": "503-658-1817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14210 SE SUNNYSIDE RD STE 100",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970155241",
            "telephone_number": "503-658-3384",
            "fax_number": "503-658-1817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUNG KIDZ DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-658-3384",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OR",
            "license": "D8094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clackamas, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.