Healthcare Provider Details

I. General information

NPI: 1013823681
Provider Name (Legal Business Name): HODA YOUSIF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1549 WHITE MOUNTAIN HWY
NORTH CONWAY NH
03860-5156
US

IV. Provider business mailing address

6601 BROADWAY APT A7
WEST NEW YORK NJ
07093-3256
US

V. Phone/Fax

Practice location:
  • Phone: 603-227-4507
  • Fax:
Mailing address:
  • Phone: 617-599-5275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number05286
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: