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General NPI Number Information
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NPI Number | 1619640380
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Entity Type | Individual
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Provider Name | TAPHAPHENE YOUNG DMD
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Gender | Female
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Dates
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Enumeration Date | 07/28/2021
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Last Update Date | 10/16/2023
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Provider Practice Location Address
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Address Line | 217 SOUTH ST
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City | HOLYOKE
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State | MA
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Zip | 01040-3611
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Country | US
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Telephone | 413-319-1078
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Fax |
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Provider Business Mailing Address
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Address Line | 217 SOUTH ST
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City | HOLYOKE
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State | MA
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Zip | 01040-3611
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Country | US
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Telephone | 413-319-1078
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DL14882
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1223D0004X
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Taxonomy Name | Dental Anesthesiology
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License Number | DN1859821
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DN1859821
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | FY1029506
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License Number State | MA
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Taxonomy #5
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN1859821
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License Number State | MA
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Taxonomy #6
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DN1859821
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License Number State | MA
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Taxonomy #7
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DN1859821
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License Number State | MA
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Taxonomy #8
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN1859821
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License Number State | MA
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