Individual provider Active NPI

Robert L Young Jr., DDS

  • Pediatric Dentistry
  • Charlotte, NC
National Provider Identifier
1043321730
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
7821 Issued in NC
Practice address
411 Billingsley Rd
Suite 106
Charlotte, NC 28211-1046
Phone
(704) 377-3694
Fax
(704) 377-9790
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 7821 NC Primary

Addresses

Primary practice location

411 Billingsley Rd
Suite 106
Charlotte, NC 28211-1046

Mailing address

23003 Norwalk LN
Fort Mill, SC 29715-6301
Phone (704) 604-1900

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

State licenses

LicenseStateTypeSpecialty
7821NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Lorette M. Polite-Young DDS PA Pediatric Dentistry Current Accepting new patients
Robert L. Young, Jr. , DDS Pediatric Dentistry Current Accepting new patients
Young and Polite Young DDS PA Pediatric Dentistry Current Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043321730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23003 NORWALK LN",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297156301",
            "telephone_number": "704-604-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 BILLINGSLEY RD",
            "address_2": "SUITE 106",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111046",
            "telephone_number": "704-377-3694",
            "fax_number": "704-377-9790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "ROBERT",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NC",
            "license": "7821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.