Sally Young, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

10099 Issued in GA

Practice address

2 Lester CT
Statesboro, GA 30458-2118

Phone

(912) 489-1386

Fax

(912) 764-8533

NPI assigned

Mar 21, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Bray, DMD & Young, DMD, PC

  • General Practice Dentistry
  • Statesboro, GA
  • NPI 1134235609

  Pediatric Dentistry

  NPD (past)

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

{
    "created_epoch": "1206057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206057600000",
    "number": "1043481609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 NORTHSIDE DR E",
            "address_2": "SUITE 5, PMB #395",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304584712",
            "telephone_number": "912-489-1386",
            "fax_number": "912-764-8533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 LESTER CT",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304582118",
            "telephone_number": "912-489-1386",
            "fax_number": "912-764-8533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "SALLY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-21",
        "last_updated": "2008-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "10099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00328314B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Kay Yaughn, PHARM. D.
• Natasha Yocco, FNP
• Charlie Brooke York
• Lauren Young
• Reann Daria Young
• Michael Youssef
• Youtherapy
• Sae Young Yu, O.D.
• Patricia Zambeck
• Lane Peyton Zeagler

• Pediatric Dentistry in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Pediatric Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2008; 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.

Verify at the official NPI Registry.