Healthcare Provider Details

I. General information

NPI: 1366732745
Provider Name (Legal Business Name): PETER YOUNG D D S INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2011
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 W HUNTINGTON DR STE 217
ARCADIA CA
91007-1529
US

IV. Provider business mailing address

301 W HUNTINGTON DR STE 217
ARCADIA CA
91007-1529
US

V. Phone/Fax

Practice location:
  • Phone: 626-445-2536
  • Fax: 626-445-0127
Mailing address:
  • Phone: 626-445-2536
  • Fax: 626-445-0127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. PETER S YOUNG
Title or Position: OWNER
Credential: DDS
Phone: 626-445-2536