Individual provider Active NPI

John M Young Jr., DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Brick, NJ
National Provider Identifier
1619043247
Registry record updated Sep 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
D1018330 Issued in NJ
Practice address
990 Cedar Bridge Ave Ste B15
Brick, NJ 08723-4158
Phone
(732) 477-1808
Fax
(732) 477-1490
NPI assigned
Nov 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X D1018330 NJ Primary

Addresses

Primary practice location

990 Cedar Bridge Ave Ste B15
Brick, NJ 08723-4158

Mailing address

990 Cedar Bridge Ave Ste B15
Brick, NJ 08723-4158
Phone (732) 477-1808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D1018330NJMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Shore Sleep Solutions LLC Orthodontics and Dentofacial Orthopedics Current Accepting new patients
Braces at Brick PA Orthodontics and Dentofacial Orthopedics Current Accepting new patients
Shore Dental Sleep Care Past Accepting new patients

Locations

990 Cedar Bridge Ave
Ste B15
Brick, NJ 08723
Phone (732) 477-1808

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536624000000",
    "number": "1619043247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 CEDAR BRIDGE AVE STE B15",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087234158",
            "telephone_number": "732-477-1808",
            "fax_number": "732-477-1490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 CEDAR BRIDGE AVE STE B15",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087234158",
            "telephone_number": "732-477-1808",
            "fax_number": "732-477-1490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JOHN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-27",
        "last_updated": "2018-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NJ",
            "license": "D1018330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; 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.