Healthcare Provider Details

I. General information

NPI: 1437501335
Provider Name (Legal Business Name): GINA M YOUNG DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2016
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 3RD ST SW
COKATO MN
55321-4595
US

IV. Provider business mailing address

521 CREEKSIDE DR
BUFFALO MN
55313-8904
US

V. Phone/Fax

Practice location:
  • Phone: 320-286-5333
  • Fax:
Mailing address:
  • Phone: 605-280-9755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD13940
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: