Jaclyn Young

Primary specialty

DentistTaxonomy code 122300000X

License

10299 Issued in AZ

Practice address

339 E Leland Rd
Pittsburg, CA 94565-4911

Phone

(925) 431-1250

NPI assigned

Mar 1, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

State licenses

Practice roles

Locations

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.

• District Medical Group, Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Phoenix, AZ
  • NPI 1336472448
  Medicare reassignment NPD
• District Medical Group, Inc

  • Anesthesiology Physician
  • Phoenix, AZ
  • NPI 1093948275
  NPD
• District Medical Group, Inc

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1144624339
  NPD
• La Clinica de la Raza Inc

  dba La Clinica Dental at Children's Hospital Oakland

  • Federally Qualified Health Center (FQHC)
  • Oakland, CA
  • NPI 1346262292
  NPD (past)
• La Clinica de la Raza Inc

  dba La Clinica Pittsburg Dental

  • Federally Qualified Health Center (FQHC)
  • Pittsburg, CA
  • NPI 1528080470
  NPD (past)

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

{
    "created_epoch": "1519862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589155200000",
    "number": "1427550813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5883 W BUFFALO PL",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852267512",
            "telephone_number": "661-877-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 E LELAND RD",
            "city": "PITTSBURG",
            "state": "CA",
            "postal_code": "945654911",
            "telephone_number": "925-431-1250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JACLYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-01",
        "last_updated": "2020-05-11",
        "certification_date": "2020-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "10299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charde Marie Wydermyer
• Annabelle Siliga Yandall
• Xiao Yang, M.D.
• Yasaman Sani, DDS Inc.
• Nydia Guadalupe Yataco, MSW
• Laura Young
• Meagan Callie Youngblood, MHRS
• Latasia Leanne Zaldivar, SUDRC
• Virginia Zavala Moreno
• Liping Zhang-Everson

• Dentist in Pittsburg, CA
• Providers in Pittsburg, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2020; 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.