Active NPI
Daniel Jone Young, DMD
- Dentist
- Long Beach, CA
National Provider Identifier
1962060194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 103729
- Practice address
- 4516 Atlantic Ave
Long Beach, CA 90807-1513 - Phone
- (562) 437-0647
- NPI assigned
- Jun 3, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 103729 | CA | Primary |
Addresses
Primary practice location
4516 Atlantic Ave
Long Beach, CA 90807-1513
Mailing address
2202 Paso Real Ave
Rowland Heights, CA 91748-3840
Phone (626) 709-7670
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
| License | State | Type | Specialty |
|---|---|---|---|
| 103729 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559520000000",
"number": "1962060194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2202 PASO REAL AVE",
"city": "ROWLAND HEIGHTS",
"state": "CA",
"postal_code": "917483840",
"telephone_number": "626-709-7670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4516 ATLANTIC AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908071513",
"telephone_number": "562-437-0647"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "DANIEL",
"middle_name": "JONE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-03",
"last_updated": "2019-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "103729",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.