Provider Demographics
NPI:1598171167
Name:YOUNG, CYNTHIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:
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 1:3845 VINEYARD AVE
Mailing Address - Street 2:APT H
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-6778
Mailing Address - Country:US
Mailing Address - Phone:916-934-4712
Mailing Address - Fax:
Practice Address - Street 1:1400 SANTA RITA RD
Practice Address - Street 2:STE A
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-5666
Practice Address - Country:US
Practice Address - Phone:925-398-3236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-03
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63578122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist