Provider Demographics
NPI:1063839751
Name:YOUSSEF, HANY (DDS,MS)
Entity Type:Individual
Prefix:
First Name:HANY
Middle Name:
Last Name:YOUSSEF
Suffix:
Gender:M
Credentials:DDS,MS
Other - Prefix:
Other - First Name:HANY
Other - Middle Name:SHAKER
Other - Last Name:YOUSSEF
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS,MS
Mailing Address - Street 1:4915 DEMPSEY AVE
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-1678
Mailing Address - Country:US
Mailing Address - Phone:949-394-5866
Mailing Address - Fax:
Practice Address - Street 1:455 S C ST
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-5917
Practice Address - Country:US
Practice Address - Phone:949-394-5866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-20
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA611531223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics