Brenton L Young, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7040 Issued in NC

Practice address

139 W Ross Grove Road
Shelby, NC 28150-3406

Phone

(704) 482-7986

Fax

(704) 480-9301

NPI assigned

Jul 10, 2006

Last updated

Sep 11, 2014By 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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410393600000",
    "number": "1982638391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 656",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281510656",
            "telephone_number": "704-482-7986",
            "fax_number": "704-480-9301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 W ROSS GROVE ROAD",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281503406",
            "telephone_number": "704-482-7986",
            "fax_number": "704-480-9301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "BRENTON",
        "middle_name": "L",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2014-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "7040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "9009L",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "899009L",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justen Daniel Wright, PA-C
• Susan C Wright, LCSW
• Pamella Machado Yamada, MD
• Japheth Angelo Youmans
• Young Young and Associates Inc
• Douglas Bryan Young, M.D.
• Eugene F Young, DDS, F.A.G.D.
• Johanna C. Young, PA-C
• Kay B. Young, AU.D.
• Lamar L. Young, PH.D.

• General Practice Dentistry in Shelby, NC
• Providers in Shelby, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.