Glenn Arthur Young, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401004523 Issued in VA

Practice address

1151 E Main St
Suite a
Radford, VA 24141-1761

Phone

(540) 639-1674

Fax

(540) 639-9205

NPI assigned

Oct 25, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in VA

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Radford Family Dental, Inc.

  • General Practice Dentistry
  • Radford, VA
  • NPI 1396815080
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205910015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 E MAIN ST",
            "address_2": "SUITE A",
            "city": "RADFORD",
            "state": "VA",
            "postal_code": "241411761",
            "telephone_number": "540-639-1674",
            "fax_number": "540-639-9205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 E MAIN ST",
            "address_2": "SUITE A",
            "city": "RADFORD",
            "state": "VA",
            "postal_code": "241411761",
            "telephone_number": "540-639-1674",
            "fax_number": "540-639-9205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "GLENN",
        "middle_name": "ARTHUR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401004523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "078358",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13651",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Well Rounded Midwifery
• Anna Whetsel Rucker
• Taylor Elizabeth Whitaker
• Lauryn Marshay Wiley, CD
• Jessica Dowdy Windle, FNP-BC
• Katherine M Zammit, PHARMD

• General Practice Dentistry in Radford, VA
• Providers in Radford, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.