Dalas Matthew Young

Primary specialty

DentistTaxonomy code 122300000X

License

13300 Issued in NC

Practice address

2090 Waterscape Way
New Bern, NC 28562

Phone

(252) 631-3260

NPI assigned

Aug 24, 2022

Last updated

May 2, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southern Oaks Dental

  • Dental Clinic/Center
  • New Bern, NC
  • NPI 1568302503
  NPD Authorized official

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1760101687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1851 MACGREGOR DOWNS RD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345925",
            "telephone_number": "252-702-5399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 WATERSCAPE WAY",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "28562",
            "telephone_number": "252-631-3260"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Barnes St",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278586102",
            "country_code": "US",
            "telephone_number": "252-702-5399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "DALAS",
        "middle_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-24",
        "last_updated": "2024-05-02",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "13300",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Leigh Wynant, LCMHC-A
• Crystal Xinico
• Brian Lorne Yaeck, OTRL
• Stephanie Nicole Yeagle
• Jennifer Elizabeth Yielding, OTR
• Garret Pickney Young, MD
• Morgan Youst
• Ruhin Yuridullah
• Grace Zalwsky
• John Zannis, M.D.

• Dentist in New Bern, NC
• Providers in New Bern, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2024; 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.