Provider Demographics
NPI:1356092225
Name:RAHA YOUSEFI DDS MPH PLLC
Entity Type:Organization
Organization Name:RAHA YOUSEFI DDS MPH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PERIODONTIST
Authorized Official - Prefix:
Authorized Official - First Name:RAHA
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUSEFI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:724-816-6393
Mailing Address - Street 1:1234 19TH ST NW STE 308
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-2468
Mailing Address - Country:US
Mailing Address - Phone:202-393-6154
Mailing Address - Fax:
Practice Address - Street 1:1234 19TH ST NW STE 308
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-2468
Practice Address - Country:US
Practice Address - Phone:202-393-6154
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-12
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty