Individual provider Active NPI

Joanne Young, D.D.S.

  • Dentist
  • Valencia, CA
National Provider Identifier
1881801389
Registry record updated Nov 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
35463 Issued in CA
Practice address
28212 Kelly Johnson Pkwy.
Suite #170
Valencia, CA 91355-5087
Phone
(661) 257-6453
Fax
(661) 257-6450
NPI assigned
May 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 35463 CA Primary

Addresses

Primary practice location

28212 Kelly Johnson Pkwy.
Suite #170
Valencia, CA 91355-5087

Mailing address

28212 Kelly Johnson Pkwy.
Suite #170
Valencia, CA 91355-5087
Phone (661) 257-6453

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160623000979 CA Order and Referring Only - DentistPractitioner - Dentist 9830480797

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35463CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Andrew Tran, DDS, a Dental Corporation 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": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478476800000",
    "number": "1881801389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28212 KELLY JOHNSON PKWY.",
            "address_2": "SUITE #170",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913555087",
            "telephone_number": "661-257-6453",
            "fax_number": "661-257-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28212 KELLY JOHNSON PKWY.",
            "address_2": "SUITE #170",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913555087",
            "telephone_number": "661-257-6453",
            "fax_number": "661-257-6450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JOANNE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2016-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "35463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valencia, CA

Sources for this page

Verify at the official NPI Registry.