Provider Demographics
NPI:1952057101
Name:JACQUELINE YOUNESI DDS INC
Entity Type:Organization
Organization Name:JACQUELINE YOUNESI DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNESI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-246-2028
Mailing Address - Street 1:1024 BAYSIDE DR # 148
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7462
Mailing Address - Country:US
Mailing Address - Phone:949-246-2028
Mailing Address - Fax:
Practice Address - Street 1:2121 E COAST HWY STE 230
Practice Address - Street 2:
Practice Address - City:CORONA DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92625-1932
Practice Address - Country:US
Practice Address - Phone:949-246-2028
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-25
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental