NPIMap

Organization Active NPI

Young and Short, a Dental Corporation

  • Dentist
  • Diamond Bar, CA
National Provider Identifier
1699863654
Registry record updated Jun 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
31170 Issued in CA
Legal business name
YOUNG AND SHORT, A DENTAL CORPORATION
Practice address
646 N Diamond Bar Blvd
Diamond Bar, CA 91765-1037
Phone
(909) 861-2661
Fax
(909) 861-6951
NPI assigned
Oct 11, 2006
Last updated
Jun 12, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2012

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

Authorized official

Name
Mr. Jerry P Young Sr., DDSNPI 1417045485
Title
President Owner
Phone
(909) 861-2661

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 31170 CA Primary
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X 32662 CA

Addresses

Primary practice location

646 N Diamond Bar Blvd
Diamond Bar, CA 91765-1037

Mailing address

646 N Diamond Bar Blvd
Diamond Bar, CA 91765-1037
Phone (909) 861-2661

National Provider Directory

National Provider Directory

Locations

646 N Diamond Bar Blvd
Diamond Bar, CA 91765
Phone (909) 861-2661

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339459200000",
    "number": "1699863654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "646 N DIAMOND BAR BLVD",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917651037",
            "telephone_number": "909-861-2661",
            "fax_number": "909-861-6951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "646 N DIAMOND BAR BLVD",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917651037",
            "telephone_number": "909-861-2661",
            "fax_number": "909-861-6951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUNG AND SHORT, A DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2012-06-12",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "909-861-2661",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "31170",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "32662",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Diamond Bar, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; 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.