Provider Demographics
NPI:1003955329
Name:YOUSEF, HODA (DMD MS)
Entity Type:Individual
Prefix:
First Name:HODA
Middle Name:
Last Name:YOUSEF
Suffix:
Gender:F
Credentials:DMD MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 SAINT CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07105-3921
Mailing Address - Country:US
Mailing Address - Phone:973-344-1184
Mailing Address - Fax:973-972-0370
Practice Address - Street 1:90 BERGEN ST STE 7700
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-2425
Practice Address - Country:US
Practice Address - Phone:973-972-2444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ50201223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics