Edward D Young DDS PC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

2901013995 Issued in MI

Legal business name

EDWARD D YOUNG DDS PC

Practice address

4310 Leonard NW
Grand Rapids, MI 49534

Phone

(616) 791-0230

NPI assigned

Oct 2, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Edward D Young, DDSNPI 1073656195

Title

President

Phone

(616) 791-0230

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Edward D Young, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Grand Rapids, MI
  • NPI 1073656195
  NPD (past) Authorized official

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154414886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 LEONARD NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49534",
            "telephone_number": "616-791-0230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4310 LEONARD NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49534",
            "telephone_number": "616-791-0230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD D YOUNG DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "616-791-0230",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MI",
            "license": "2901013995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4563730",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deandrea Edmonds
• Carrie A Edmunds
• Edp of Mi, PC
• Michelle Edsall, LLMSW
• Roger W. Edvenson, M.D.
• Anita Joy Edwards, COTA/L
• Azia Edwards
• Colin Edwards
• Gretchen Edwards
• Jon'Naya C Edwards, BT

• Orthodontics and Dentofacial Orthopedics Dentistry in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.