Provider Demographics
NPI:1275798704
Name:YOUNG, JONATHAN (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:
Last Name:YOUNG
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3011 HARRAH DR
Mailing Address - Street 2:SUITE H
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174-6252
Mailing Address - Country:US
Mailing Address - Phone:615-243-7535
Mailing Address - Fax:
Practice Address - Street 1:3011 HARRAH DR
Practice Address - Street 2:SUITE H
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-6252
Practice Address - Country:US
Practice Address - Phone:615-243-7535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-24
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN93541223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics