Provider Demographics
NPI:1093842460
Name:YOUSSEF, JOESEF R (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOESEF
Middle Name:R
Last Name:YOUSSEF
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 1:21839 VENTURA BLVD
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-1838
Mailing Address - Country:US
Mailing Address - Phone:818-347-8444
Mailing Address - Fax:818-347-8442
Practice Address - Street 1:21839 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-1838
Practice Address - Country:US
Practice Address - Phone:818-347-8444
Practice Address - Fax:818-347-8442
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD505501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice