Provider Demographics
NPI:1558055905
Name:YOUNG, KAYLIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:KAYLIN
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3002 HIGHWAY 284
Mailing Address - Street 2:
Mailing Address - City:IVA
Mailing Address - State:SC
Mailing Address - Zip Code:29655-7822
Mailing Address - Country:US
Mailing Address - Phone:864-328-4053
Mailing Address - Fax:
Practice Address - Street 1:1100 FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-2715
Practice Address - Country:US
Practice Address - Phone:504-619-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-07
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCDGD.10525122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist