Healthcare Provider Details

I. General information

NPI: 1114730017
Provider Name (Legal Business Name): PAYTON YOUNG DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PAYTON VALURE

II. Dates (important events)

Enumeration Date: 01/27/2025
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 WEBB PL STE 150
DOVER NH
03820-2459
US

IV. Provider business mailing address

13 OLD CHESTER RD
DERRY NH
03038-4017
US

V. Phone/Fax

Practice location:
  • Phone: 603-617-2882
  • Fax:
Mailing address:
  • Phone: 603-479-6840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number05355
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: