Active NPI
Joseph B. Young, D.M.D.
- General Practice Dentistry
- Aurora, OR
National Provider Identifier
1730318601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D9430
- Practice address
- 21668 Highway 99E NE
Aurora, OR 97002-9200 - Phone
- (503) 678-7787
- NPI assigned
- Jul 13, 2009
- Last updated
- Apr 21, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 143 | HI | |
| General Practice Dentistry | 1223G0001X | D9430 | OR | Primary |
Addresses
Primary practice location
21668 Highway 99E NE
Aurora, OR 97002-9200
Mailing address
21668 Highway 99E NE
Aurora, OR 97002-9200
Phone (503) 678-7787
Other practice location 1
1301 Punchbowl St
Honolulu, HI 96813-2402
Phone (808) 547-4292
Other practice location 2
8890 S Grizzly Bear Ct
Canby, OR 97013-9515
Phone (503) 621-8216
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 534819 | Medicaid | HI |
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 |
|---|---|---|---|
| 143 | HI | MD | General Practice Dentistry |
| D9430 | OR | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618963200000",
"number": "1730318601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21668 HIGHWAY 99E NE",
"city": "AURORA",
"state": "OR",
"postal_code": "970029200",
"telephone_number": "503-678-7787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21668 HIGHWAY 99E NE",
"city": "AURORA",
"state": "OR",
"postal_code": "970029200",
"telephone_number": "503-678-7787"
}
],
"practiceLocations": [
{
"address_1": "1301 Punchbowl St",
"address_purpose": "LOCATION",
"city": "Honolulu",
"state": "HI",
"postal_code": "968132402",
"country_code": "US",
"telephone_number": "808-547-4292",
"fax_number": "808-585-5028",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "8890 S Grizzly Bear Ct",
"address_purpose": "LOCATION",
"city": "Canby",
"state": "OR",
"postal_code": "970139515",
"country_code": "US",
"telephone_number": "503-621-8216",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "YOUNG",
"first_name": "JOSEPH",
"middle_name": "B.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-07-13",
"last_updated": "2021-04-21",
"certification_date": "2021-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "HI",
"license": "143",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OR",
"license": "D9430",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "534819",
"state": "HI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Aurora, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.