NPIMap

Organization Active NPI

Nipomo Dental Group of Andrew Young DDS Inc

  • Dental Clinic/Center
  • Nipomo, CA
National Provider Identifier
1134747124
Registry record updated Jul 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
NIPOMO DENTAL GROUP OF ANDREW YOUNG DDS INC
Practice address
255 N Wilson St Ste D
Nipomo, CA 93444-7830
Phone
(805) 270-9322
NPI assigned
Jul 7, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2020

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

Authorized official

Name
Andrew Young, DDSNPI 1548431117
Title
President
Phone
(805) 270-9322

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

255 N Wilson St Ste D
Nipomo, CA 93444-7830

Mailing address

PO Box 309
Nipomo, CA 93444-0309

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1594080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594080000000",
    "number": "1134747124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 309",
            "city": "NIPOMO",
            "state": "CA",
            "postal_code": "934440309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 N WILSON ST STE D",
            "city": "NIPOMO",
            "state": "CA",
            "postal_code": "934447830",
            "telephone_number": "805-270-9322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIPOMO DENTAL GROUP OF ANDREW YOUNG DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-07",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-270-9322",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nipomo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.