Provider Demographics
NPI:1932406360
Name:YOUNG, LASHICA M (DDS)
Entity Type:Individual
Prefix:DR
First Name:LASHICA
Middle Name:M
Last Name:YOUNG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15530 W 64TH AVE UNIT H
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80007-6874
Mailing Address - Country:US
Mailing Address - Phone:303-422-3746
Mailing Address - Fax:303-422-5811
Practice Address - Street 1:15530 W 64TH AVE UNIT H
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80007-6874
Practice Address - Country:US
Practice Address - Phone:303-422-3746
Practice Address - Fax:303-422-5811
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-21
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO107251223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO32604033Medicaid