Provider Demographics
NPI:1821381351
Name:YOUSEFI, RAHA (DDS)
Entity Type:Individual
Prefix:DR
First Name:RAHA
Middle Name:
Last Name:YOUSEFI
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 1:4007 CONNECTICUT AVE NW
Mailing Address - Street 2:212
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-1103
Mailing Address - Country:US
Mailing Address - Phone:301-537-3995
Mailing Address - Fax:
Practice Address - Street 1:3 WASHINGTON CIR NW
Practice Address - Street 2:SUITE G
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-2356
Practice Address - Country:US
Practice Address - Phone:202-785-9474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-17
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN10009411223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics