NPIMap

Organization Active NPI

Young Orthodontics PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Evansville, IN
National Provider Identifier
1558893768
Registry record updated Mar 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
12011014A Issued in IN
Legal business name
YOUNG ORTHODONTICS PC
Practice address
5108 Bellemeade Ave
Evansville, IN 47715-4134
Phone
(812) 477-9294
NPI assigned
Mar 28, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2017

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

Authorized official

Name
Dr. Derrick Robert Young, DDS MSDNPI 1437488665
Title
President
Phone
(812) 639-8443

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 12011014A IN Primary

Addresses

Primary practice location

5108 Bellemeade Ave
Evansville, IN 47715-4134

Mailing address

5108 Bellemeade Ave
Evansville, IN 47715-4134

National Provider Directory

National Provider Directory

Locations

5108 Bellemeade Ave
Evansville, IN 47715
Phone (812) 477-9294

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490659200000",
    "number": "1558893768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5108 BELLEMEADE AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477154134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5108 BELLEMEADE AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477154134",
            "telephone_number": "812-477-9294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUNG ORTHODONTICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-28",
        "last_updated": "2017-03-28",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-639-8443",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS MSD"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IN",
            "license": "12011014A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2017; 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.