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General NPI Number Information
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NPI Number | 1942555859
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Entity Type | Individual
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Provider Name | YOUNG S YI D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/17/2012
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Last Update Date | 07/24/2023
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Provider Practice Location Address
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Address Line | 290 BAKER AVE STE N228
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City | CONCORD
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State | MA
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Zip | 01742-2192
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Country | US
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Telephone | 978-369-7771
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Fax |
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Provider Business Mailing Address
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Address Line | 219 BOSTON POST RD W
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City | MARLBOROUGH
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State | MA
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Zip | 01752-4605
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Country | US
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Telephone | 508-481-8161
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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 | DN1857550
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN1857550
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License Number State | MA
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