Individual provider Active NPI

David Allen Young, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Wyomissing, PA
National Provider Identifier
1619468022
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DS041809 Issued in PA
Practice address
1075 Berkshire Blvd Ste 800
Wyomissing, PA 19610-1264
Phone
(610) 374-4093
Fax
(610) 375-6454
NPI assigned
May 21, 2018
Last updated
Jan 19, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DS041809 PA Primary
Student in an Organized Health Care Education/Training Program 390200000X PA

Addresses

Primary practice location

1075 Berkshire Blvd Ste 800
Wyomissing, PA 19610-1264

Mailing address

909 Walnut St RM 300
Philadelphia, PA 19107-5211
Phone (215) 503-7118

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jun 9, 2023 through Jun 9, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS041809PAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Berks Oral Surgery LTD Oral and Maxillofacial Surgery CurrentSince Jan 22, 2023 Accepting new patients
Berks Oral Surgery, PLLC Oral and Maxillofacial Surgery PastSince Jan 22, 2023 Accepting new patients

Locations

1075 Berkshire Blvd
Ste 800
Wyomissing, PA 19610
Phone (610) 374-4093

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1526860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1619468022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 WALNUT ST RM 300",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075211",
            "telephone_number": "215-503-7118",
            "fax_number": "215-923-9189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 BERKSHIRE BLVD STE 800",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101264",
            "telephone_number": "610-374-4093",
            "fax_number": "610-375-6454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "DAVID",
        "middle_name": "ALLEN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-21",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS041809",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

Verify at the official NPI Registry.