Active NPI
Michael James Young, DDS
- General Practice Dentistry
- Lafayette, LA
National Provider Identifier
1780774885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 5513 LA
- Practice address
- 626 Verot School Rd
Suite D
Lafayette, LA 70508-5094 - Phone
- (337) 237-6453
- Fax
- (337) 237-6422
- NPI assigned
- Oct 13, 2006
- Last updated
- Jul 8, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5513 LA | LA | Primary |
Addresses
Primary practice location
626 Verot School Rd
Suite D
Lafayette, LA 70508-5094
Mailing address
626 Verot School Rd
Suite D
Lafayette, LA 70508-5094
Phone (337) 237-6453
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1589205 | Other | LA | UNITED CONCORDIA PIN |
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 |
|---|---|---|---|
| 5513 LA | LA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1780774885",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "626 VEROT SCHOOL RD",
"address_2": "SUITE D",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705085094",
"telephone_number": "337-237-6453",
"fax_number": "337-237-6422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "626 VEROT SCHOOL RD",
"address_2": "SUITE D",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705085094",
"telephone_number": "337-237-6453",
"fax_number": "337-237-6422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "MICHAEL",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "LA",
"license": "5513 LA",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA PIN",
"identifier": "1589205",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.