Eric Philip Youngner, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

D12645 Issued in MN

Practice address

800 California Ave W
Saint Paul, MN 55117-3456

Phone

(763) 639-7196

NPI assigned

Jun 3, 2009

Sex

Male

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective May 11, 2015 through May 11, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1243987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245283200000",
    "number": "1124254248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11800 ABERDEEN ST NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554494808",
            "telephone_number": "763-639-7196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 CALIFORNIA AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551173456",
            "telephone_number": "763-639-7196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNGNER",
        "first_name": "ERIC",
        "middle_name": "PHILIP",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-03",
        "last_updated": "2009-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D12645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madeline Young, R.D, L.D.
• Martyja Young
• Richard J Young, PH.D.
• Samuel Douglas Young
• Susan Young
• Alyssa Jayne Youngquist, LICSW
• Mary Elizabeth Youngquist, PH.D. L.P.
• Rebecca Ann Younk, AU.D.
• Your Path, LLC
• Yourpath Care, PLLC

• Dentist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2009; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.