Individual provider Active NPI

Samantha Tory Young, DMD

  • General Practice Dentistry
  • Irving, TX
National Provider Identifier
1922784131
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
39586 Issued in TX
Practice address
2240 Market Place Blvd Ste 120
Irving, TX 75063-8075
Phone
(469) 747-2404
NPI assigned
Jun 22, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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 39586 TX Primary

Addresses

Primary practice location

2240 Market Place Blvd Ste 120
Irving, TX 75063-8075

Mailing address

2043 Miracle Point Dr
Southlake, TX 76092-7917
Phone (512) 962-2800

Other practice location 1

3529 Heritage Trace Pkwy Ste 171
Fort Worth, TX 76244-4971
Phone (817) 741-4567

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
39586TXMDPharmacotherapy Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
E.Q. 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": "1687392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1922784131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2043 MIRACLE POINT DR",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760927917",
            "telephone_number": "512-962-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 MARKET PLACE BLVD STE 120",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750638075",
            "telephone_number": "469-747-2404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3529 Heritage Trace Pkwy Ste 171",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "762444971",
            "country_code": "US",
            "telephone_number": "817-741-4567",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "SAMANTHA",
        "middle_name": "TORY",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-22",
        "last_updated": "2023-06-22",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "39586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; 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.