Active NPI
Lisa B Young, D.D.S.
- Dentist
- Wellington, FL
National Provider Identifier
1285717066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN17516
- Practice address
- 1035 South State Road 7
Suite 212
Wellington, FL 33414 - Phone
- (561) 333-2545
- NPI assigned
- Oct 23, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN17516 | FL | Primary |
Addresses
Primary practice location
1035 South State Road 7
Suite 212
Wellington, FL 33414
Mailing address
5900 W Sample Rd
Apartment 103
Coral Springs, FL 33067-3248
Phone (954) 753-0878
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 |
|---|---|---|---|
| DN17516 | FL | MD | Dentist |
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1285717066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5900 W SAMPLE RD",
"address_2": "APARTMENT 103",
"city": "CORAL SPRINGS",
"state": "FL",
"postal_code": "330673248",
"telephone_number": "954-753-0878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1035 SOUTH STATE ROAD 7",
"address_2": "SUITE 212",
"city": "WELLINGTON",
"state": "FL",
"postal_code": "33414",
"telephone_number": "561-333-2545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "LISA",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN17516",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wellington, FL
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.