Provider Demographics
NPI:1558972083
Name:YOUSEF, TAREQ (DDS)
Entity type:Individual
Prefix:DR
First Name:TAREQ
Middle Name:
Last Name:YOUSEF
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8043 TREVOR PL
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-4032
Mailing Address - Country:US
Mailing Address - Phone:703-626-0616
Mailing Address - Fax:
Practice Address - Street 1:1553 ALABAMA AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-5054
Practice Address - Country:US
Practice Address - Phone:202-610-3300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-10
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN1002218122300000X
VA0401417266122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist