DR. JERRY E YOUNG (NPI# 1669573424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669573424 |
| Entity Type | Individual |
| Full Name | DR. JERRY E YOUNG |
| Credential | D.D.S. |
| Practice Address |
208 West 4th Street Holton KS 66436 |
| Mailing Address |
208 West 4th Street P.o. Box 1028 Holton KS 66436 |
| Practice Telephone | 7853644636 |
| Practice Fax Number | 7853644815 |
| Mailing Telephone | 7853644636 |
| Mailing Fax Number | 7853644815 |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
4625 | KS | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | BLUE CROSS & BLUE SHIELD | 17207 | 01 |
| KS | UNITED OF CONCORDIA | 627506 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609077957 | Jerry A Young | Dentist | 14 E Silver St, Lebanon, OH 45036-1804 | 2007-05-31 |
| 1154408235 | Jerry D Young | Surgery | 600 Hospital Cir, Suite 201, Bay City, TX 77414-4771 | 2006-11-01 |
| 1538244504 | Jerry Lee Young | Pharmacist | 154 Main St, Decatur, AR 72722 | 2006-10-26 |
| 1417045485 | Jerry P. Young | Dentist | 646 N Diamond Bar Blvd, Diamond Bar, CA 91765-1037 | 2006-10-11 |
| 1104857333 | Jerry Tuck Young | Optometrist | 623 E Matthews Ave, Jonesboro, AR 72401-3145 | 2006-07-05 |
| 1760458871 | Jerry V Young | Anesthesiology | 550 University Blvd, Indianapolis, IN 46202-5149 | 2006-02-28 |
| Street Address |
208 WEST 4TH STREET |
| City | HOLTON |
| State | KS |
| Zip Code | 66436 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578664330 | Jerry E. Young, D.d.s., P.a. | Dentist | 208 West 4th Street, Holton, KS 66436 | 2006-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528180734 | William E. Kinkade IIi | Physician Assistant | 1100 Columbine Drive, Holton, KS 66436 | 2007-04-06 |
| 1710943634 | Ladona Marie Schmidt | Family Medicine | 1110 Columbine Drive, Holton, KS 66436 | 2006-04-21 |
| 1669917688 | Deanna Lynn Goff | Nurse Practitioner | 1110 Columbine Drive, Holton, KS 66436 | 2016-12-29 |
| 1316384332 | Dallas W Dooley | Registered Nurse | 1100 Columbine Dr, Holton, KS 66436 | 2013-05-31 |
| 1114362050 | Erin R. Locke | Family Medicine | 1100 Columbine Drive, Tacoma Family Medicine, Holton, KS 66436 | 2013-05-06 |
| 1336487412 | Jill S Collins | Nurse Practitioner | 1110 Columbine Drive, Holton, KS 66436 | 2013-01-23 |
| 1164442687 | Holton Usd 336 Holton Special Education Cooperative | Local Education Agency (LEA) | 515 Pennsylvania Ave, Holton, KS 66436 | 2006-07-20 |
| 1619947744 | Jana D Kramer | Family Medicine | 1603 W 4th St, Holton, KS 66436 | 2006-01-23 |
| 1962923938 | Ryan Smalley | Psychologist | 713 Idaho Ave, Holton, KS 66436-1103 | 2017-06-29 |
| 1457385882 | Medicalodges, Inc. | Skilled Nursing Facility | 1121 W 7th St, Holton, KS 66436-1123 | 2006-07-10 |
| Find all providers in zip 66436 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700193091 | Rutherford-peterson Dentistry LLC | Dentist | 208 W 4th St, Holton, KS 66436-1784 | 2010-09-08 |
| 1114455482 | Michael Martin Myers | Dentist | 208 W 4th St, Holton, KS 66436-1784 | 2017-05-31 |
| 1659718963 | Samantha Cruz Rieschick | Dentist | 1100 Columbine Dr, Holton, KS 66436-8841 | 2013-05-28 |
| 1720398241 | Holton Dental Inc. | Dentist | 1100 Columbine Dr, Holton, KS 66436-8841 | 2010-10-18 |
| 1578664330 | Jerry E. Young, D.d.s., P.a. | Dentist | 208 West 4th Street, Holton, KS 66436 | 2006-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780290205 | Centurion/mhm/centene | Dentist | 11130 Rd E, Norton, KS 67654 | 2020-09-21 |
| 1023620523 | Shibin Yu | Dentist | 13705 Manor, Leawood, KS 66224-4523 | 2020-08-18 |
| 1770192767 | Mackenzie Colson | Dentist | 5611 W 134th Ter Apt 1718, Leawood, KS 66209-4060 | 2020-07-27 |
| 1104434463 | Vaidehi Trivedi | Dentist | 10818 Parallel Pkwy # Ks, Kansas City, KS 66109-3649 | 2020-07-22 |
| 1326656117 | Joel David Piper | Dentist | 10840 Shawnee Mission Pkwy, Shawnee, KS 66203-3512 | 2020-07-17 |
| 1184241044 | Celsus LLC | Dentist | 3110 Nieder Rd, Lawrence, KS 66047-1950 | 2020-06-26 |
| 1609405398 | Upcare Dental Olathe LLC | Dentist | 790 N Ridgeview Rd, Olathe, KS 66061-2900 | 2020-04-03 |
| 1144852302 | Rosenberg Dentistry: Joe Rosenberg Dds. Pa | Dentist | 1037 Sheridan Suite D, Great Bend, KS 67530 | 2020-02-06 |
| 1063052777 | Threemondds LLC | Dentist | 7524 State Ave, Kansas City, KS 66112-2816 | 2020-01-10 |
| 1427606706 | Nathan A Laskowski | Dentist | 3507 S 4th St. Trafficway, Leavenworth, KS 66048 | 2019-08-29 |
| Find all providers with the same taxonomy | ||||
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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.