Active NPI
Michael Andrew Young, D.D.S.
- General Practice Dentistry
- Cedar Park, TX
National Provider Identifier
1790230365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 32120
- Practice address
- 1455 E Whitestone Blvd
Cedar Park, TX 78613-7722 - Phone
- (512) 259-7171
- NPI assigned
- Aug 23, 2016
- Sex
- Male
- Sole proprietor
- Yes
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 | 32120 | TX | Primary |
Addresses
Primary practice location
1455 E Whitestone Blvd
Cedar Park, TX 78613-7722
Mailing address
3211 Palm Way Apt 2221
Austin, TX 78758-7888
Phone (817) 673-8166
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170427002659 | TX | Order and Referring Only - Dentist | 4587941646 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32120 | TX | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471910400000",
"number": "1790230365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3211 PALM WAY APT 2221",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787587888",
"telephone_number": "817-673-8166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1455 E WHITESTONE BLVD",
"city": "CEDAR PARK",
"state": "TX",
"postal_code": "786137722",
"telephone_number": "512-259-7171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "MICHAEL",
"middle_name": "ANDREW",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-08-23",
"last_updated": "2016-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "32120",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cedar Park, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.