Alexander Deyoung, D.D.S.
Individual provider Active NPI Dentist · Cabot, PA
NPI 1487091815 · NPPES record last updated Jun 19, 2014
Key facts
- NPI
- 1487091815
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DS039822 (PA)
- Practice address
- 530 Helmbold Ave
Cabot, PA 16023-9748 - Phone
- (724) 822-8938
- NPI assigned
- May 24, 2013
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 4, 2023 through Jan 4, 2027
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS039822 | PA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deyoung Dentistry, LLC | Current |
Accepting new patients | |
| Mabry and Mabry Dentistry, LLC | Past | Accepting new patients |
Locations
2601 Boniface Pkwy
Ste 1
Anchorage, AK 99504
Phone (907) 337-9448
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS039822 | PA | Yes |
Addresses
Primary practice location
530 Helmbold Ave
Cabot, PA 16023-9748
Mailing address
530 Helmbold Ave
Cabot, PA 16023-9748
Phone (724) 822-8938
Other providers in Cabot, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 19, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.