Provider Demographics
NPI:1245439108
Name:TABRIZI, YOUNES JONAH (DDS)
Entity type:Individual
Prefix:DR
First Name:YOUNES
Middle Name:JONAH
Last Name:TABRIZI
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 1:993 GOVERNOR DR
Mailing Address - Street 2:STE 104
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-4290
Mailing Address - Country:US
Mailing Address - Phone:916-941-1515
Mailing Address - Fax:916-941-0505
Practice Address - Street 1:993 GOVERNOR DR STE 104
Practice Address - Street 2:
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-4290
Practice Address - Country:US
Practice Address - Phone:916-941-1515
Practice Address - Fax:916-941-0505
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-12
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55779122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist