John D. Young III, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

D12925 Issued in TX

Practice address

2829 Babcock Rd
Suite 126
San Antonio, TX 78229-6028

Phone

(210) 692-9556

Fax

(210) 692-0909

NPI assigned

Oct 9, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212624000000",
    "number": "1689761645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2829 BABCOCK RD",
            "address_2": "SUITE 126",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782296028",
            "telephone_number": "210-692-9556",
            "fax_number": "210-692-0909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2829 BABCOCK RD",
            "address_2": "SUITE 126",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782296028",
            "telephone_number": "210-692-9556",
            "fax_number": "210-692-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JOHN",
        "middle_name": "D.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-09",
        "last_updated": "2008-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "D12925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110902701",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIELD",
            "identifier": "D12925",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110902702",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Haven Allan Young, LP
• Jane Young
• Jayson B Young, PA-C
• Jeremiah Young
• Joanna Young, PHARMD
• John Robert Young, A.T.C., L.A.T.
• Joshua Scott Young, ATC, LAT
• Lee Ann E Young, LCSW
• Robert Michael Young, MD
• Shardae Young

• Oral and Maxillofacial Surgery (Dentist) in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Oral and Maxillofacial Surgery (Dentist) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.

Verify at the official NPI Registry.