Jeanette M. Young, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

DN014390 Issued in GA

Practice address

2635 Lee Rd
Suite C-4
Lithia Springs, GA 30122-3356

Phone

(770) 489-9141

NPI assigned

Dec 17, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Dentalwise, LLC

  • Dentist
  • Lithia Springs, GA
  • NPI 1316366271
  NPD (past)
• Value Smiles

  • Dentist
  • Lithia Springs, GA
  • NPI 1821465691
  NPD (past)

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

{
    "created_epoch": "1261008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383091200000",
    "number": "1396074589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 E PACES FERRY RD NE",
            "address_2": "APT 415",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303261124",
            "telephone_number": "202-870-2293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2635 LEE RD",
            "address_2": "SUITE C-4",
            "city": "LITHIA SPRINGS",
            "state": "GA",
            "postal_code": "301223356",
            "telephone_number": "770-489-9141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JEANETTE",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-17",
        "last_updated": "2013-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KS",
            "license": "60732",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN014390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Elizabeth Wishon, PA-C, MMSC
• Wyatt'S RX LLC
• Jacqueline Wynter, OTR/L
• Earl Y Young, MD
• Freddie Young
• Shermica Young, RN
• Ratidzo Macharaga Zgambo, OD
• ZZ Logistics LLC

• Dentist in Lithia Springs, GA
• Providers in Lithia Springs, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2013; 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.