Shelley Young DDS

Primary specialty

DentistTaxonomy code 122300000X

License

019023983 Issued in IL

Legal business name

SHELLEY YOUNG DDS

Doing business as

Universal Smiles

Practice address

17080 D. Park Ave.
South Holland, IL 60473-3349

Phone

(708) 933-0747

Fax

(708) 933-6247

NPI assigned

Mar 25, 2008

Last updated

Aug 13, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Shelley Ann Young, D.D.S.

Title

Executive Director

Phone

(708) 933-0747

Specialties & licenses 1

Addresses

Other names 1

• Universal Smiles Doing business as

Locations

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

{
    "created_epoch": "1206403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723507200000",
    "number": "1336311810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17080 D. PARK AVE.",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604733349",
            "telephone_number": "708-933-0747",
            "fax_number": "708-933-6247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17080 D. PARK AVE.",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604733349",
            "telephone_number": "708-933-0747",
            "fax_number": "708-933-6247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELLEY YOUNG DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-25",
        "last_updated": "2024-08-13",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "708-933-0747",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019023983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Universal Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in South Holland, IL
• Providers in South Holland, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.