Active NPI
Ronald Lee Young, DMD
- General Practice Dentistry
- Loma Linda, CA
National Provider Identifier
1679720734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 53384
- Practice address
- 11092 Anderson Streeet
Llu School of Dentistry
Loma Linda, CA 92350 - Phone
- (909) 558-4613
- Fax
- (909) 558-4192
- NPI assigned
- Aug 20, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 53384 | CA | Primary |
Addresses
Primary practice location
11092 Anderson Streeet
Llu School of Dentistry
Loma Linda, CA 92350
Mailing address
11092 Anderson Street
Llu School of Dentistry
Loma Linda, CA 92350
Phone (909) 558-4613
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 53384 | Other | CA | STATE LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 53384 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219190400000",
"number": "1679720734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11092 ANDERSON STREET",
"address_2": "LLU SCHOOL OF DENTISTRY",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "92350",
"telephone_number": "909-558-4613",
"fax_number": "909-558-4192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11092 ANDERSON STREEET",
"address_2": "LLU SCHOOL OF DENTISTRY",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "92350",
"telephone_number": "909-558-4613",
"fax_number": "909-558-4192"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "RONALD",
"middle_name": "LEE",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-08-20",
"last_updated": "2008-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "53384",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "53384",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Loma Linda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.