Individual provider Active NPI

Gregory Young, DDS

  • General Practice Dentistry
  • Livonia, MI
National Provider Identifier
1982773222
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901012212 Issued in MI
Practice address
38000 Ann Arbor TRL
Livonia, MI 48150-2453
Phone
(734) 591-3636
Fax
(734) 591-3535
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 2901012212 MI Primary

Addresses

Primary practice location

38000 Ann Arbor TRL
Livonia, MI 48150-2453

Mailing address

38000 Ann Arbor TRL
Livonia, MI 48150-2453
Phone (734) 591-3636

Other identifiers 1

IdentifierTypeStateIssuer
2901012212OtherMILICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200622002341 MI Practitioner - Oral SurgeryPractitioner - Sleep MedicinePractitioner - General PracticePractitioner - Dentist 4385772656

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901012212MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Dental Group 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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982773222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38000 ANN ARBOR TRL",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481502453",
            "telephone_number": "734-591-3636",
            "fax_number": "734-591-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38000 ANN ARBOR TRL",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481502453",
            "telephone_number": "734-591-3636",
            "fax_number": "734-591-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901012212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "2901012212",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.