Nicolas Kent Young, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7364346-9922 Issued in UT

Practice address

2476 N University Pkwy
Ste 103
Provo, UT 84604-3868

Phone

(801) 377-0990

NPI assigned

Jun 26, 2009

Last updated

Jun 26, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nicolas K. Young, D.M.D., Inc.

  dba Canyon Gate Dental

  • Dental Clinic/Center
  • Orem, UT
  • NPI 1184234460
  NPD Authorized official
• Canyon Gate Dental Care LLC

  • General Practice Dentistry
  • Orem, UT
  • NPI 1548506058
  NPD (past)

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

{
    "created_epoch": "1245974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245974400000",
    "number": "1932337045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2476 N UNIVERSITY PKWY",
            "address_2": "STE 103",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043868",
            "telephone_number": "801-377-0990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2476 N UNIVERSITY PKWY",
            "address_2": "STE 103",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043868",
            "telephone_number": "801-377-0990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "NICOLAS",
        "middle_name": "KENT",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-26",
        "last_updated": "2009-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "7364346-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heidi Young
• Jacqueline Jade Young, FNP-C
• Kelly Young
• Kimberly Young
• Leah Toshina Young, PA-S
• Steven W Young, M.S.P.T.
• Terry Lee Young, HSW
• Theresa Ellen Young, LCSW
• Tiffany Young
• William Tyler Young

• General Practice Dentistry in Provo, UT
• Providers in Provo, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2009; 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.