Healthcare Provider Details

I. General information

NPI: 1063839751
Provider Name (Legal Business Name): HANY YOUSSEF DDS,MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: HANY SHAKER YOUSSEF DDS,MS

II. Dates (important events)

Enumeration Date: 03/20/2014
Last Update Date: 03/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 S C ST
OXNARD CA
93030-5917
US

IV. Provider business mailing address

4915 DEMPSEY AVE
ENCINO CA
91436-1678
US

V. Phone/Fax

Practice location:
  • Phone: 949-394-5866
  • Fax:
Mailing address:
  • Phone: 949-394-5866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number61153
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: