MEDICARE: BABAK YOUSEFI DDS

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	12760	NC

General Provider Information

NPI Number	:	1427787134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BABAK YOUSEFI DDS

Provider Business Mailing Address
First Line	:	114 WOODBRIDGE LN
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27514-1831
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	114 WOODBRIDGE LN
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27514-1831
Country	:	US
Telephone Number	:	919-448-6363
Fax Number	:

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

Provider Enumeration Date	:	06/08/2022
Last Update Date	:	06/08/2022

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