Amy K. Deyoung, DDS, Ms, PC Pediatric Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

16365 Issued in MI

Legal business name

AMY K. DEYOUNG, DDS, MS, PC PEDIATRIC DENTISTRY

Practice address

3297 Eagle Run Dr. NE
Grand Rapids, MI 49525

Phone

(616) 447-7900

Fax

(616) 447-7902

NPI assigned

Nov 20, 2017

Last updated

Nov 20, 2017By 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

Dr. Amy K Deyoung, DDS, MSNPI 1386683530

Title

Owner

Phone

(616) 447-7900

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amy Kay Deyoung, DDS, MS

  • Pediatric Dentistry
  • Grand Rapids, MI
  • NPI 1386683530
  Authorized official Same address or phone

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

{
    "created_epoch": "1511136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511136000000",
    "number": "1568976017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3297 EAGLE RUN DR. NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49525",
            "telephone_number": "616-447-7900",
            "fax_number": "616-447-7902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3297 EAGLE RUN DR. NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49525",
            "telephone_number": "616-447-7900",
            "fax_number": "616-447-7902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMY K. DEYOUNG, DDS, MS, PC PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-20",
        "last_updated": "2017-11-20",
        "status": "A",
        "authorized_official_last_name": "DEYOUNG",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-447-7900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MI",
            "license": "16365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Dentistry in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Pediatric Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.