Provider Demographics
NPI:1851553994
Name:RAZAVI, YOUSEF
Entity Type:Individual
Prefix:MR
First Name:YOUSEF
Middle Name:
Last Name:RAZAVI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 ELIZABETH ST
Mailing Address - Street 2:UNIT #C1
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514
Mailing Address - Country:US
Mailing Address - Phone:919-926-0408
Mailing Address - Fax:
Practice Address - Street 1:101 WOODWINGS INDSUTRIAL COURT
Practice Address - Street 2:SUITE M
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:25711
Practice Address - Country:US
Practice Address - Phone:919-461-9655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8613122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist