Healthcare Provider Details

I. General information

NPI: 1811088040
Provider Name (Legal Business Name): HANAN G. YOUSSEF D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3520 W OKLAHOMA AVE
MILWAUKEE WI
53215-4175
US

IV. Provider business mailing address

10620 N WOOD CREST DR
MEQUON WI
53092-6418
US

V. Phone/Fax

Practice location:
  • Phone: 414-587-9114
  • Fax: 262-512-1827
Mailing address:
  • Phone: 414-587-9114
  • Fax: 262-512-1827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number019026945
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number6483-15
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: