Karissa Young, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

29991 Issued in TX

Practice address

3113 Ross St
Amarillo, TX 79103-2700

Phone

(806) 374-7341

Fax

(806) 322-0533

NPI assigned

Jun 27, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Karissa A Gonzalez Former name

Medicare fee-for-service enrollment

Enrolled in TX

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

Interoperability endpoints

• Direct secure messaging: karissa.young.1@12120.direct.athenahealth.com

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

{
    "created_epoch": "1403827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1265847248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3113 ROSS ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791032700",
            "telephone_number": "806-374-7341",
            "fax_number": "806-322-0533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3113 ROSS ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791032700",
            "telephone_number": "806-374-7341",
            "fax_number": "806-322-0533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "KARISSA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-27",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "29991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARISSA",
            "last_name": "GONZALEZ",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Roxane York
• Amanda Ann Young, NNP-BC
• Charissa Young, NP
• Hanna Dru Young, CCC-SLP
• John M Young, MD
• Katie Dawn Young, COTA
• Kristy Lynn Young, FNP
• Rachael Lee Young, LCSW
• Rodney Young, MD
• Joe Dale Youngblood, R.PH

• General Practice Dentistry in Amarillo, TX
• Providers in Amarillo, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; 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.