Individual provider Active NPI

Daniel J Young, DMD

  • General Practice Dentistry
  • Louisville, KY
National Provider Identifier
1881757284
Registry record updated Dec 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6819 Issued in KY
Practice address
4906 Bardstown Rd
Suite 106
Louisville, KY 40291-1759
Phone
(502) 499-9770
Fax
(502) 499-9796
NPI assigned
Dec 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6819 KY Primary

Addresses

Primary practice location

4906 Bardstown Rd
Suite 106
Louisville, KY 40291-1759

Mailing address

4906 Bardstown Rd
Suite 106
Louisville, KY 40291-1759
Phone (502) 499-9770

Other identifiers 2

IdentifierTypeStateIssuer
6000191400MedicaidKY
431515OtherKYUNITED CONCORDIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200630001467 KY Order and Referring Only - DentistPractitioner - Dentist 6709208291

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6819KYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Young & Young Dental General Practice 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.

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196812800000",
    "number": "1881757284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4906 BARDSTOWN RD",
            "address_2": "SUITE 106",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402911759",
            "telephone_number": "502-499-9770",
            "fax_number": "502-499-9796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4906 BARDSTOWN RD",
            "address_2": "SUITE 106",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402911759",
            "telephone_number": "502-499-9770",
            "fax_number": "502-499-9796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "DANIEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2007-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "6819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6000191400",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "431515",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.