Provider Demographics
NPI:1497061212
Name:YOUNG, STEPHEN SCOTT (DDS)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:SCOTT
Last Name:YOUNG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 WESTBRIAR DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23238-5013
Mailing Address - Country:US
Mailing Address - Phone:804-741-2812
Mailing Address - Fax:804-741-4193
Practice Address - Street 1:1107 WESTBRIAR DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23238-5013
Practice Address - Country:US
Practice Address - Phone:804-741-2812
Practice Address - Fax:804-741-4193
Is Sole Proprietor?:No
Enumeration Date:2010-08-31
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA69221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice