Provider Demographics
NPI:1548595762
Name:YOUNG, VICTOR J (DDS)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:J
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 1:23101 SHERMAN PL STE 315
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-2007
Mailing Address - Country:US
Mailing Address - Phone:818-340-9077
Mailing Address - Fax:
Practice Address - Street 1:23101 SHERMAN PL
Practice Address - Street 2:STE. 315
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-2003
Practice Address - Country:US
Practice Address - Phone:818-340-9077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-06
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA324181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice