Healthcare Provider Details

I. General information

NPI: 1588157036
Provider Name (Legal Business Name): YASSER K OBAID DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2018
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 E ORANGEBURG AVE STE 150
MODESTO CA
95355-3396
US

IV. Provider business mailing address

2401 E ORANGEBURG AVE STE 150
MODESTO CA
95355-3396
US

V. Phone/Fax

Practice location:
  • Phone: 209-809-0123
  • Fax: 209-549-0173
Mailing address:
  • Phone: 209-809-0123
  • Fax: 209-549-0173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number107899
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: