Provider Demographics
NPI:1760498968
Name:YOUNG, ANDREW TAIWAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:TAIWAN
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 1:1930 ALCOA HWY., MED. BLDG. A
Mailing Address - Street 2:SUITE 340
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1500
Mailing Address - Country:US
Mailing Address - Phone:865-305-9440
Mailing Address - Fax:865-305-9442
Practice Address - Street 1:1930 ALCOA HWY., MED. BLDG. A
Practice Address - Street 2:SUITE 340
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1500
Practice Address - Country:US
Practice Address - Phone:865-305-9440
Practice Address - Fax:865-305-9442
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN83191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice