Provider Demographics
NPI:1235347006
Name:YOUNG, KRICKET C (DDS)
Entity Type:Individual
Prefix:DR
First Name:KRICKET
Middle Name:C
Last Name:YOUNG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 WHEATLAND DR
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67502-5667
Mailing Address - Country:US
Mailing Address - Phone:620-663-5044
Mailing Address - Fax:620-663-5094
Practice Address - Street 1:1311 WHEATLAND DR
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67502-5667
Practice Address - Country:US
Practice Address - Phone:620-663-5044
Practice Address - Fax:620-663-5094
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS71201223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100316670BMedicaid