Provider Demographics
NPI:1932464831
Name:MOHAMMAD, YUSIF (DDS)
Entity Type:Individual
Prefix:DR
First Name:YUSIF
Middle Name:
Last Name:MOHAMMAD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 SW MILITARY DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78221-1650
Mailing Address - Country:US
Mailing Address - Phone:210-922-3483
Mailing Address - Fax:210-610-5887
Practice Address - Street 1:125 SW MILITARY DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78221-1650
Practice Address - Country:US
Practice Address - Phone:210-922-3483
Practice Address - Fax:210-610-5887
Is Sole Proprietor?:No
Enumeration Date:2012-07-08
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX281461223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry