Healthcare Provider Details

I. General information

NPI: 1366388167
Provider Name (Legal Business Name): YOUSIF ALKAWAZ DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1602 WESTEN ST
BOWLING GREEN KY
42104-4156
US

IV. Provider business mailing address

567 COOKSEY LN APT 4731
BOWLING GREEN KY
42103-9179
US

V. Phone/Fax

Practice location:
  • Phone: 270-781-1706
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD-00223
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: