Active NPI
James M Young, DDS
- Endodontics
- Jbsa Lackland, TX
National Provider Identifier
1194707554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 39329
- Practice address
- 1615 Truemper St BLDG 6418
Jbsa Lackland, TX 78236-5511 - Phone
- (210) 292-0650
- NPI assigned
- Nov 18, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | DT-2049 | HI | |
| General Practice Dentistry | 1223G0001X | 2049 | HI | |
| Endodontics | 1223E0200X | 39329 | TX | Primary |
Addresses
Primary practice location
1615 Truemper St BLDG 6418
Jbsa Lackland, TX 78236-5511
Mailing address
1615 Truemper St BLDG 6418
Jbsa Lackland, TX 78236-5511
Phone (210) 292-0650
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DT-2049 | HI | MD | Endodontist |
| 39329 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696896000000",
"number": "1194707554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1615 TRUEMPER ST BLDG 6418",
"city": "JBSA LACKLAND",
"state": "TX",
"postal_code": "782365511",
"telephone_number": "210-292-0650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1615 TRUEMPER ST BLDG 6418",
"city": "JBSA LACKLAND",
"state": "TX",
"postal_code": "782365511",
"telephone_number": "210-292-0650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "JAMES",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-18",
"last_updated": "2023-10-10",
"certification_date": "2023-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "HI",
"license": "DT-2049",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "HI",
"license": "2049",
"primary": false
},
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "TX",
"license": "39329",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jbsa Lackland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.