Ayoung Jo

Primary specialty

DentistTaxonomy code 122300000X

License

40442 Issued in TX

Practice address

301 E US Highway 377 Ste 100
Granbury, TX 76048-1201

Phone

(817) 776-4337

NPI assigned

Mar 20, 2023

Sex

Female

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": "1679270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1821790338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E US HIGHWAY 377 STE 100",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760481201",
            "telephone_number": "817-776-4337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E US HIGHWAY 377 STE 100",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760481201",
            "telephone_number": "817-776-4337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3302 Gaston Ave",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752462013",
            "country_code": "US",
            "telephone_number": "214-828-8215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JO",
        "first_name": "AYOUNG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-20",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "40442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joan G Jaeckle, LCSW
• Amanda Lynn Jarvis, WHNP
• Jason a Berry DDS PA
• Ruston Ladd Jennings, M.D.
• Dallas Lei Jessie, SLP ASSISTANT
• Zachary Robert Johnson, PT
• Laura Jones
• Rebecca Jones, LCDC-I
• Marchetta Jordan
• Sarah Tison Jordan, M.D.

• Dentist in Granbury, TX
• Providers in Granbury, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.