MEDICARE: STEPHEN S. YOUNG, D.D.S., P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	0401006922	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ANTEHM	OTHER	VA	ANTHEM DENTAL INSURANCE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053372151
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEPHEN S. YOUNG, D.D.S., P.C.

Provider Business Mailing Address
First Line	:	1107 WESTBRIAR DR
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23238-5013
Country	:	US
Telephone Number	:	804-741-2812
Fax Number	:

Provider Business Practice Location Address
First Line	:	1107 WESTBRIAR DR
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23238-5013
Country	:	US
Telephone Number	:	804-741-2812
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/DENTIST/OWNER
Name	:	DR. STEPHEN SCOTT YOUNG
Credential	:	D.D.S.
Telephone Number	:	804-741-2812

Provider Enumeration Date	:	03/29/2006
Last Update Date	:	09/14/2011

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