Individual provider Active NPI

Ian Dylan Young, D.M.D.

  • Dentist
  • Gilbert, AZ
National Provider Identifier
1710187885
Registry record updated Jul 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7315 Issued in AZ
Practice address
2483 S Market St Ste 101
Gilbert, AZ 85295-0722
Phone
(480) 857-1044
Fax
(480) 840-3200
NPI assigned
Jul 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7315 AZ Primary

Addresses

Primary practice location

2483 S Market St Ste 101
Gilbert, AZ 85295-0722

Mailing address

1445 W 18TH Ave
Apache Junction, AZ 85220-6348
Phone (480) 452-4293

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150811004931 AZ Order and Referring Only - DentistPractitioner - Dentist 1052626645

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
San Tan Dental Group, LLP General Practice Past Accepting new patients

Organizations & group practices 1

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": "1184716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215734400000",
    "number": "1710187885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 W 18TH AVE",
            "city": "APACHE JUNCTION",
            "state": "AZ",
            "postal_code": "852206348",
            "telephone_number": "480-452-4293",
            "fax_number": "480-833-3336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2483 S MARKET ST STE 101",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852950722",
            "telephone_number": "480-857-1044",
            "fax_number": "480-840-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "IAN",
        "middle_name": "DYLAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-18",
        "last_updated": "2008-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "7315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.