Individual provider Active NPI

Christopher Young, DDS

  • Dentist
  • Honolulu, HI
National Provider Identifier
1588067177
Registry record updated Sep 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2559 Issued in HI
Practice address
4747 Kilauea Ave
Suite 109
Honolulu, HI 96816-5308
Phone
(808) 732-3368
NPI assigned
Sep 26, 2014
Last updated
Sep 26, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2559 HI Primary

Addresses

Primary practice location

4747 Kilauea Ave
Suite 109
Honolulu, HI 96816-5308

Mailing address

4747 Kilauea Ave
Suite 109
Honolulu, HI 96816-5308
Phone (808) 732-3368

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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

Enrollment IDStateProvider typePAC IDDetails
I20150713001688 HI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6608189105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2559HIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1411689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411689600000",
    "number": "1588067177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4747 KILAUEA AVE",
            "address_2": "SUITE 109",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968165308",
            "telephone_number": "808-732-3368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4747 KILAUEA AVE",
            "address_2": "SUITE 109",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968165308",
            "telephone_number": "808-732-3368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "CHRISTOPHER",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-26",
        "last_updated": "2014-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "HI",
            "license": "2559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.