DR. KEITH YOUNG (NPI# 1154597110) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154597110 |
| Entity Type | Individual |
| Full Name | DR. KEITH YOUNG |
| Credential | D.D.S. |
| Practice Address |
5381 N Socrum Loop Rd Lakeland FL 33809-4272 |
| Practice Telephone | 8638153313 |
| Practice Fax Number | 8638168750 |
| Mailing Telephone | 8638153313 |
| Mailing Fax Number | 8638168750 |
| Enumeration Date | 2008-04-30 |
| Last Update Date | 2008-04-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | DN15083 | FL | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | DRIVER LICENSE | Y520500541410 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417939414 | Keith P Young | Internal Medicine | 400 N State of Franklin Rd Rm 2746, Johnson City, TN 37604-6035 | 2005-11-16 |
| 1821125071 | Keith William Young | Psychiatry & Neurology | 10780 Santa Monica Blvd, Suite 250, Los Angeles, CA 90025-4749 | 2007-02-27 |
| 1114087251 | Keith Young | Counselor | 175 Union St Ste C, Bangor, ME 04401-6116 | 2006-12-11 |
| 1295817443 | Keith Leung Young | Dentist | 37070 Newark Blvd, C, Newark, CA 94560-3798 | 2006-10-19 |
| 1629089859 | Keith R Young | Internal Medicine | 500 University Dr, Hershey, PA 17033-2360 | 2006-08-11 |
| 1003854258 | Keith Young | Family Medicine | 205 S Mccrary St, Woodbury, TN 37190-1439 | 2006-06-02 |
| 1346220274 | Keith B Young | Physician Assistant | 112 W Main St, Allegany, NY 14706-1204 | 2006-01-18 |
| Street Address |
5381 N SOCRUM LOOP RD |
| City | LAKELAND |
| State | FL |
| Zip Code | 33809-4272 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063506285 | Miriam Simon | Dentist | 5381 N Socrum Loop Rd, Lakeland, FL 33809-4272 | 2006-10-03 |
| 1548448376 | Janice Perez | Dentist | 5381 N Socrum Loop Rd, Ste 8, Lakeland, FL 33809-4272 | 2008-02-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861018178 | John C Gallik | Military Health Care Provider | 3176 Corporal Johnson Road, Jbsa Fort Sam Houston, TX 33809 | 2020-06-23 |
| 1376189209 | Julie Independence Tomchak | Nurse's Aide | 7805 Us Highway Lot 29 # 98 N, Lakeland, FL 33809 | 2019-11-26 |
| 1912465923 | Lakeland Oaks Nh LLC | Skilled Nursing Facility | 855 Carpenters Way, Lakeland, FL 33809 | 2019-03-08 |
| 1235528753 | Christia Mccann | Physician Assistant | 4120 Us Hwy. 98 N., One Lakeland Square, Lakeland, FL 33809 | 2015-01-21 |
| 1548679616 | Ashley Frances Hamarowicz | Physical Therapist | 771 Carpenters Way, Lakeland, FL 33809 | 2014-08-04 |
| 1750700860 | Grace Manor Suites | Assisted Living Facility | 4620 N Socrum Loop Road, Lakeland, FL 33809 | 2014-04-16 |
| 1164769980 | Christopher Fisher | Hearing Instrument Specialist | 3800 North Rd 98, Ste 500, Lakeland, FL 33809 | 2013-01-14 |
| 1023374063 | Eagle Lake Pharmacy Inc | Pharmacy | 5245 A U S Hwy 98 N, Suite A, Lakeland, FL 33809 | 2012-04-04 |
| 1851669675 | Reginald Keith Jenkins | Pharmacist | 1043 Walt Williams Road, Lakeland, FL 33809 | 2011-12-07 |
| 1578859633 | Jill Margaret Waldrop | Pharmacist | 6600 N. Socrum Loop, Lakeland, FL 33809 | 2011-06-27 |
| Find all providers in zip 33809 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407344435 | Dentists of Lakeland, Pa | Dentist | 3700 Us Highway 98 N Ste 105, Lakeland, FL 33809-3809 | 2018-04-25 |
| 1235649518 | Lakeland Modern Dentistry, Pa | Dentist | 4620 S Florida Ave Ste 120, Lakeland, FL 33813-2166 | 2017-10-02 |
| 1316497134 | Dental Associates of Florida (s. Lakeland) Pllc | Dentist | 444 W Pipkin Rd, Lakeland, FL 33813-2612 | 2016-10-05 |
| 1023564903 | Georges Raffoul | Dentist | 2744 South Florida Ave, Lakeland, FL 33584 | 2016-08-30 |
| 1295289171 | Kendrah Lynn Harper | Dentist | 600 W Peachtree St, Lakeland, FL 33815-1504 | 2016-08-09 |
| 1033560586 | Charles D. Llano, D.d.s. | Dentist | 320 West Highland Drive, Lakeland, FL 33813 | 2016-06-27 |
| 1144605320 | Austin Jordan Davis | Dentist | 8950 Us Highway 64 Ste 108, Lakeland, TN 38002-4566 | 2015-07-29 |
| 1407105083 | Elena Kan | Dentist | 5644 Vintage View Boulevard, Lakeland, FL 33812 | 2012-08-29 |
| 1174827901 | Affordable Dentures - Lakeland, P.a. | Dentist | 3615 S Florida Ave Ste 1230, Lakeland, FL 33803-4808 | 2011-01-09 |
| 1407164502 | Shannon Holer Kelso | Dentist | 2156 Harden Blvd., Lakeland, FL 33803 | 2010-09-23 |
| Find all providers in LAKELAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.