1871681197 NPI number — A ALLAN YOUNG DDS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871681197 NPI number — A ALLAN YOUNG DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
A ALLAN YOUNG DDS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1871681197
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
657 CAMINO DE LOS MARES
Provider Second Line Business Mailing Address:
# 132
Provider Business Mailing Address City Name:
SAN CLEMENTE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92673
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
949-496-1221
Provider Business Mailing Address Fax Number:
949-496-1242

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
657 CAMINO DE LOS MARES
Provider Second Line Business Practice Location Address:
# 132
Provider Business Practice Location Address City Name:
SAN CLEMENTE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92673
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-496-1221
Provider Business Practice Location Address Fax Number:
949-496-1242
Provider Enumeration Date:
10/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
YOUNG
Authorized Official First Name:
ANDREW
Authorized Official Middle Name:
ALLAN
Authorized Official Title or Position:
DENTIST OWNER
Authorized Official Telephone Number:
949-496-1221

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  23880 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com