=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447590260
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RANIA HASSAN YOUNIS BDS,MDS,PHD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/15/2013
-----------------------------------------------------
Last Update Date | 08/18/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6865 DEERPATH RD STE 302
-----------------------------------------------------
City | ELKRIDGE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21075-6254
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-796-3333
-----------------------------------------------------
Fax | 410-796-3375
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8516 TIMBER HILL CT
-----------------------------------------------------
City | ELLICOTT CITY
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21043-6069
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-814-9128
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223P0106X
-----------------------------------------------------
Taxonomy Name | Oral and Maxillofacial Pathology Dentistry
-----------------------------------------------------
License Number | 17436
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1223P0106X
-----------------------------------------------------
Taxonomy Name | Oral and Maxillofacial Pathology Dentistry
-----------------------------------------------------
License Number | 80
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------