Young at Heart Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

7055 Issued in CO

Legal business name

YOUNG AT HEART DENTISTRY

Practice address

2603 Vinewood LN
Pueblo, CO 81005-3370

Phone

(719) 564-6464

Fax

(719) 564-1818

NPI assigned

May 8, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Michael J Purcell, DDS

Title

Owner

Phone

(719) 543-7123

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200614400000",
    "number": "1962615492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2603 VINEWOOD LN",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810053370",
            "telephone_number": "719-564-6464",
            "fax_number": "719-564-1818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2603 VINEWOOD LN",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810053370",
            "telephone_number": "719-564-6464",
            "fax_number": "719-564-1818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUNG AT HEART DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2008-01-18",
        "status": "A",
        "authorized_official_last_name": "PURCELL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-543-7123",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CO",
            "license": "7055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "91284546",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jamie Yi
• Charlotte K Yianakopulos-Veatch
• Maegan Yoder
• Ashley Youmans, OTR/L
• Young and Graham, P.C.
• Donald J Young, NP
• Eric M Young, D.C
• Kathy Ann Young
• Melissa Lyn Young, FNP
• Regan Young, LCSW, CACIII

• Pediatric Dentistry in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Pediatric Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2008; 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.