Tiffany Petulia Young, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

57601 Issued in CA

Practice address

412 W Colorado St
Suite C
Glendale, CA 91204-3097

Phone

(818) 244-4063

NPI assigned

Sep 4, 2008

Last updated

Sep 4, 2008By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in NV

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dentist

Education

Univ of Calif, San Francisco School of Dentistry, 2008

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rd Prabhu-Lata K Shete MDS LTD

  • Multi-Specialty Clinic/Center
  • Las Vegas, NV
  • NPI 1912995309
  Medicare reassignment

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

{
    "created_epoch": "1220486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220486400000",
    "number": "1083862858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 W COLORADO ST",
            "address_2": "SUITE C",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912043097",
            "telephone_number": "818-244-4063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 W COLORADO ST",
            "address_2": "SUITE C",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912043097",
            "telephone_number": "818-244-4063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "TIFFANY",
        "middle_name": "PETULIA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-04",
        "last_updated": "2008-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "57601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rahaf Younan, RPH
• Young Headwaters
• Candace A Young, PH.D.
• Careen Young, AU.D.
• Peter P Young Jr., D.M.D.
• Your Best Care Home Health
• Your Bestcare Hospice Inc
• Your Comfort Care Inc
• Your Path Transportation LLC
• Anika Yousefian, MD, MPH

• General Practice Dentistry in Glendale, CA
• Providers in Glendale, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.