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General NPI Number Information
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NPI Number | 1902761133
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Entity Type | Organization
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Legal Business Name | MY DENTAL HUB
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Dates
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Enumeration Date | 12/19/2025
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Last Update Date | 12/19/2025
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Provider Practice Location Address
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Address Line | 4905 OLD ORCHARD SHOPPING CTR UNIT 221,
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City | SKOKIE
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State | IL
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Zip | 60077
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Country | US
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Telephone | 847-674-2463
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Fax |
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Provider Business Mailing Address
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Address Line | 4905 OLD ORCHARD SHOPPING CENTER SUITE 221
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City | SKOKIE
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State | IL
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Zip | 60077
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Country | US
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Telephone | 847-674-2463
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. MOUSTAFA YOUSSEF
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Credential | DDS
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Telephone | 585-309-7431
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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