Provider Demographics
NPI:1225744394
Name:YOUSUF AL-ABOOSI DDS LLC
Entity Type:Organization
Organization Name:YOUSUF AL-ABOOSI DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YOUSUF
Authorized Official - Middle Name:
Authorized Official - Last Name:AL-ABOOSI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:412-258-5087
Mailing Address - Street 1:15200 SHADY GROVE RD STE 440
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-6231
Mailing Address - Country:US
Mailing Address - Phone:301-869-5595
Mailing Address - Fax:
Practice Address - Street 1:15200 SHADY GROVE RD STE 440
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6231
Practice Address - Country:US
Practice Address - Phone:301-869-5595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty