Randall Scott De Young, DDS

Dentist · Wyoming, MI

Individual Active NPI

NPI number 1104493410

Practice location

1869 Porter St SW
Wyoming, MI 49519-1709
Phone
(616) 532-7601

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NPI record

NPI
1104493410
Entity type
Individual (Type 1)
Enumeration date
June 6, 2021
Last updated
October 7, 2022
Certified
October 7, 2022
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X 2901600996 MI
Dentist 122300000X RES.004364 OH

Mailing address

2709 144TH Ave
Dorr, MI 49323-9707
Phone
(616) 821-3851

About Dr. De Young

Randall Scott De Young, DDS is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 1869 Porter St SW, Wyoming, MI 49519-1709. The NPI number 1104493410 was assigned on June 6, 2021 and the record was last updated on October 7, 2022.

Dr. De Young lists 2 licenses in the registry: #2901600996 (MI) for Dentist; #RES.004364 (OH) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Randall Scott De Young, DDS?

The NPI number is 1104493410.

What is the phone number of Dr. De Young?

The phone number listed for the practice location is (616) 532-7601.

Where is Dr. De Young located?

1869 Porter St SW, Wyoming, MI 49519-1709.

What is the taxonomy code for Dr. De Young?

The primary taxonomy code is 122300000X – Dentist; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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