Provider Demographics
NPI:1417568080
Name:MEKHAEL, YOUSTINA ALBER (DDS)
Entity Type:Individual
Prefix:DR
First Name:YOUSTINA
Middle Name:ALBER
Last Name:MEKHAEL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24898 SANITARIUM DR # 94
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92350-1717
Mailing Address - Country:US
Mailing Address - Phone:951-533-4185
Mailing Address - Fax:
Practice Address - Street 1:24898 SANITARIUM DR # 94
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92350-1717
Practice Address - Country:US
Practice Address - Phone:951-533-4185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-16
Last Update Date:2020-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA105261122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist