IndividualActive
Bailey Youngblade, DDS
NPI 1508540147 · Dentist · Pewaukee, WI
Provider details
- NPI number
- 1508540147
- Entity type
- Individual
- Primary specialty
- DentistDental Providers
- Credential
- DDS
- Sex
- Female
- Sole proprietor
- No
- License
- 39656 (TX)
Specialties & taxonomies
Dental Providers
Practice location
617 Ryan St Ste 270
Pewaukee, WI 53072-1880
Phone: (262) 695-8600
Fax: (262) 691-3469
Approximate (ZIP-level) locationGet directions
Mailing address
617 Ryan St Ste 270
Pewaukee, WI 53072-1880
Registry dates
- Enumerated
- 2023-06-14
- Last updated
- 2025-09-05
- Certified
- 2025-09-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.