Provider Demographics
NPI:1457935546
Name:ANWAR, YOUSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:YOUSEPH
Middle Name:
Last Name:ANWAR
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 1:844 CHRISTY CT
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95376-8719
Mailing Address - Country:US
Mailing Address - Phone:510-364-2535
Mailing Address - Fax:
Practice Address - Street 1:3150 SANTA RITA RD STE 1
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-8300
Practice Address - Country:US
Practice Address - Phone:925-892-4479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-06
Last Update Date:2024-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10008226122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty