Individual provider Active NPI

Nelson E Young Jr., DMD

  • General Practice Dentistry
  • Lexington, KY
National Provider Identifier
1740369313
Registry record updated Jun 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8117 Issued in KY
Practice address
496 Southland Dr
Lexington, KY 40503-1827
Phone
(859) 288-2425
Fax
(859) 288-7510
NPI assigned
Nov 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 8117 KY Primary

Addresses

Primary practice location

496 Southland Dr
Lexington, KY 40503-1827

Mailing address

496 Southland Dr
Lexington, KY 40503-1827
Phone (859) 288-2392

Other identifiers 1

IdentifierTypeStateIssuer
6000333200MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20160420002625 KY Practitioner - Oral Surgery 0143460139 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8117KYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Healthfirst Bluegrass Inc. CurrentSince Mar 7, 2016 Accepting new patients
Healthfirst Bluegrass Inc CurrentSince Mar 7, 2016 Accepting new patients

Locations

576 E Third St
Ste 170
Lexington, KY 40508
Phone (859) 288-2478

1060 Goodwin Dr
#110
Lexington, KY 40505

555 E Fifth St
Lexington, KY 40508
Phone (859) 252-2371

1640 Bryan Station Rd
Ste 1
Lexington, KY 40505

122 Arceme Ave
Lexington, KY 40505

161 Bruce St
Lexington, KY 40507
Phone (859) 381-3418

1113 Centre Pkwy
Lexington, KY 40517
Phone (859) 381-3606

551 Parkside Dr
Lexington, KY 40505
Phone (859) 381-3512

496 Southland Dr
Lexington, KY 40503
Phone (859) 288-2392

2101 Saint Mathilda Dr
Lexington, KY 40502
Phone (859) 381-3273

650 Newtown Pike
Lexington, KY 40508
Phone (859) 252-2371

218 Mandalay Rd
Lexington, KY 40504
Phone (859) 381-3340

707 Howard St
Lexington, KY 40508
Phone (859) 381-3263

Organizations & group practices 2

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": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559520000000",
    "number": "1740369313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "496 SOUTHLAND DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405031827",
            "telephone_number": "859-288-2392",
            "fax_number": "859-721-3918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "496 SOUTHLAND DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405031827",
            "telephone_number": "859-288-2425",
            "fax_number": "859-288-7510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "NELSON",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2019-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "8117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6000333200",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.