Provider Demographics
NPI:1225052020
Name:YOUNG, DENISE ANNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:ANNE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:DENISE
Other - Middle Name:ANNE
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:544 N SEMORAN BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32807-3326
Mailing Address - Country:US
Mailing Address - Phone:954-517-1721
Mailing Address - Fax:954-436-3628
Practice Address - Street 1:544 N SEMORAN BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-3326
Practice Address - Country:US
Practice Address - Phone:954-517-1721
Practice Address - Fax:954-436-3628
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN146921223G0001X, 1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No1223G0001XDental ProvidersDentistGeneral Practice