Active NPI
Donald R Young, DDS
- General Practice Dentistry
- Port Hadlock, WA
National Provider Identifier
1801828280
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 6308
- Practice address
- 906 Ness Corner Rd
Port Hadlock, WA 98339-9429 - Phone
- (360) 385-4373
- Fax
- (360) 385-2252
- NPI assigned
- Jul 7, 2006
- 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 | 6308 | WA | Primary |
Addresses
Primary practice location
906 Ness Corner Rd
Port Hadlock, WA 98339-9429
Mailing address
PO Box 268
906 Ness Corner Rd
Port Hadlock, WA 98339-0268
Phone (360) 385-4373
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00635 | Other | WA | WASHINGTON DENTAL SERVICE |
| 504613 | Other | HI | HAWAII DENTAL SERVICE |
| 862087 | Other | WA | UNITED CONCORDIA INS CO |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6308 | WA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Port Hadlock Dental Center Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dental Clinic/Center
- Port Hadlock, WA
- NPI 1902350689
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457395200000",
"number": "1801828280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 268",
"address_2": "906 NESS CORNER RD",
"city": "PORT HADLOCK",
"state": "WA",
"postal_code": "983390268",
"telephone_number": "360-385-4373",
"fax_number": "360-385-2252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "906 NESS CORNER RD",
"city": "PORT HADLOCK",
"state": "WA",
"postal_code": "983399429",
"telephone_number": "360-385-4373",
"fax_number": "360-385-2252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "DONALD",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-07",
"last_updated": "2016-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WA",
"license": "6308",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WASHINGTON DENTAL SERVICE",
"identifier": "00635",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HAWAII DENTAL SERVICE",
"identifier": "504613",
"state": "HI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA INS CO",
"identifier": "862087",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Port Hadlock, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.