Roland I. Young, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

29538 Issued in CA

Practice address

1316 Coffee Rd
Ste. E-14
Modesto, CA 95355-3191

Phone

(209) 522-9963

Fax

(209) 522-5184

NPI assigned

Apr 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609832427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1316 COFFEE RD",
            "address_2": "STE. E-14",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953553191",
            "telephone_number": "209-522-9963",
            "fax_number": "209-522-5184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1316 COFFEE RD",
            "address_2": "STE. E-14",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953553191",
            "telephone_number": "209-522-9963",
            "fax_number": "209-522-5184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "ROLAND",
        "middle_name": "I.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "29538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B29538-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kylee Ann Young, PA-C
• Laura Mae Young, OD
• Nakia Lanae Young
• Nik Anderson Young
• Ricardo B. Young, MD
• Nadia Yousef, MD
• Violet Yousef
• George Yousip
• Youth for Christ Central Valley
• Alexander Ka Jun Yu, DO

• Oral and Maxillofacial Surgery (Dentist) in Modesto, CA
• Providers in Modesto, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.