Provider Demographics
NPI:1336429281
Name:YOUSEFI, ASHKAN (DMD)
Entity Type:Individual
Prefix:
First Name:ASHKAN
Middle Name:
Last Name:YOUSEFI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1028 S WALTER REED DR
Mailing Address - Street 2:APT 310
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-0815
Mailing Address - Country:US
Mailing Address - Phone:408-888-9240
Mailing Address - Fax:202-861-7731
Practice Address - Street 1:1712 I ST NW
Practice Address - Street 2:SUITE 910
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-3702
Practice Address - Country:US
Practice Address - Phone:202-861-7730
Practice Address - Fax:202-861-7731
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-24
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN1001046122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist