NPIMap

Organization Active NPI

William Bruce Young DMD

  • General Practice Dentistry
  • Jacksonville, AL
National Provider Identifier
1114234010
Registry record updated Sep 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3308 Issued in AL
Legal business name
WILLIAM BRUCE YOUNG DMD
Practice address
505 Pelham Rd S
Ste a
Jacksonville, AL 36265-2775
Phone
(256) 435-4464
Fax
(256) 435-2079
NPI assigned
Sep 13, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2010

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

Authorized official

Name
Dr. William Bruce Young, DMD
Title
Dentist/Owner
Phone
(256) 435-4464

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 3308 AL Primary
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X 4566 AL

Addresses

Primary practice location

505 Pelham Rd S
Ste a
Jacksonville, AL 36265-2775

Mailing address

505 Pelham Rd S
Ste a
Jacksonville, AL 36265-2775
Phone (256) 435-4464

National Provider Directory

National Provider Directory
Tax ID family
Regional Dental Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

505 Pelham Rd S
Ste A
Jacksonville, AL 36265
Phone (256) 435-4464

NPI Registry JSON

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

{
    "created_epoch": "1284336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284336000000",
    "number": "1114234010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 PELHAM RD S",
            "address_2": "STE A",
            "city": "JACKSONVILLE",
            "state": "AL",
            "postal_code": "362652775",
            "telephone_number": "256-435-4464",
            "fax_number": "256-435-2079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 PELHAM RD S",
            "address_2": "STE A",
            "city": "JACKSONVILLE",
            "state": "AL",
            "postal_code": "362652775",
            "telephone_number": "256-435-4464",
            "fax_number": "256-435-2079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM BRUCE YOUNG DMD",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-13",
        "last_updated": "2010-09-13",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "256-435-4464",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "3308",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AL",
            "license": "4566",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2010; 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.