Provider Demographics
NPI:1427434356
Name:KO, ANDY YOUNG (DDS)
Entity type:Individual
Prefix:DR
First Name:ANDY
Middle Name:YOUNG
Last Name:KO
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 1:11311 MONTSERRAT ST
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-5319
Mailing Address - Country:US
Mailing Address - Phone:714-334-7707
Mailing Address - Fax:
Practice Address - Street 1:16424 BELLFLOWER BLVD
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-5415
Practice Address - Country:US
Practice Address - Phone:562-804-1468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-03
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA645691223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry