MEDICARE: DR. JOSHUA CONNOR YOUNIS DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	12781	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12781	OTHER	NC	NCSBDE

General Provider Information

NPI Number	:	1275272510
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSHUA CONNOR YOUNIS DMD

Provider Business Mailing Address
First Line	:	1608 SEATTLE SLEW CT
Second Line	:
City	:	WAXHAW
State	:	NC
Zip	:	28173-6642
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11300 CRESTHILL DR STE 105
Second Line	:
City	:	MINT HILL
State	:	NC
Zip	:	28227-7992
Country	:	US
Telephone Number	:	704-323-7577
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2022
Last Update Date	:	06/03/2022

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