Keane Wayne Young, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

100982 Issued in CA

Practice address

38056 Martha Ave
Fremont, CA 94536-3809

Phone

(510) 505-9409

NPI assigned

Oct 24, 2017

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

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

{
    "created_epoch": "1508803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1760994214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 NORTHRIDGE DR",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940154608",
            "telephone_number": "415-509-1867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38056 MARTHA AVE",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945363809",
            "telephone_number": "510-505-9409"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "265 16th St",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "CA",
            "postal_code": "948013214",
            "country_code": "US",
            "telephone_number": "415-509-1867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "KEANE",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-24",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "100982",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "100982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal Young, RDN
• Ebony T Young
• Edgar T. Young, CADC II, CAS II
• Jessica Young, NP
• Julia Young, D.M.D.
• Marly Young
• Raymond Young, M.D.
• Asadullah Yousafzai
• Julie Nessim Youssef, D.O., MPH
• Youssef E Youssef, M.D.

• General Practice Dentistry in Fremont, CA
• Providers in Fremont, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.