Individual provider Active NPI

Evan Graham Young, D.D.S.

  • General Practice Dentistry
  • Anchorage, AK
National Provider Identifier
1124256417
Registry record updated Jul 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1295 Issued in AK
Practice address
2000 Abbott Rd
Suite 100
Anchorage, AK 99507-3878
Phone
(907) 349-5585
NPI assigned
Jun 25, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1295 AK Primary

Addresses

Primary practice location

2000 Abbott Rd
Suite 100
Anchorage, AK 99507-3878

Mailing address

2000 Abbott Rd
Suite 100
Anchorage, AK 99507-3878
Phone (907) 349-5585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341446400000",
    "number": "1124256417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 ABBOTT RD",
            "address_2": "SUITE 100",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995073878",
            "telephone_number": "907-349-5585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 ABBOTT RD",
            "address_2": "SUITE 100",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995073878",
            "telephone_number": "907-349-5585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "EVAN",
        "middle_name": "GRAHAM",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-25",
        "last_updated": "2012-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AK",
            "license": "1295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2012; 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.