Dennis Youngblood, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

17244 Issued in TX

Practice address

4800 Lakewood Ranch Blvd
Bradenton, FL 34211-4953

Phone

(941) 405-1504

NPI assigned

May 5, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Lake Erie College of Osteopathic Medicine

  dba LECOM School of Dental Medicine

  • General Practice Dentistry
  • Bradenton, FL
  • NPI 1912258872
  NPD (past)
• Market Street Family Dental,PLLC

  • General Practice Dentistry
  • Cedar Park, TX
  • NPI 1831528512
  NPD (past)

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

{
    "created_epoch": "1209945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583884800000",
    "number": "1083880454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 LAKEWOOD RANCH BLVD",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342114953",
            "telephone_number": "941-405-1504",
            "fax_number": "941-405-1675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 LAKEWOOD RANCH BLVD",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342114953",
            "telephone_number": "941-405-1504"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5400 Lbj Fwy",
            "address_2": "SUITE 944",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752401000",
            "country_code": "US",
            "telephone_number": "972-982-8490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNGBLOOD",
        "first_name": "DENNIS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-05",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "17244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dyoungblood@lecom.edu",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4800 Lakewood Ranch Blvd",
            "city": "Bradenton",
            "state": "FL",
            "country_code": "US",
            "postal_code": "342114953",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer L Young, PT
• Katrina Young, BA
• Krystal Tiffany Young
• Nicole Lee Young, LCSW
• Shara L Young, MD
• Ellen L. Younghaus, L.M.H.C.
• Kailyn Youngs
• Your Health First LLC (Kauffman Chiropractic)
• Jennifer Yu, MD
• Angelina Yui

• Oral and Maxillofacial Surgery (Dentist) in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.