Healthcare Provider Details

I. General information

NPI: 1316458797
Provider Name (Legal Business Name): MARC YOUKEL DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2017
Last Update Date: 11/16/2025
Certification Date: 11/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2072 E SOUTHERN AVE STE A103
TEMPE AZ
85282-7500
US

IV. Provider business mailing address

7025 E VIA SOLERI DR APT 4004
SCOTTSDALE AZ
85251-1428
US

V. Phone/Fax

Practice location:
  • Phone: 480-756-0194
  • Fax:
Mailing address:
  • Phone: 802-355-9545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number012632
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: