MEDICARE: SELMA YOUSIF YOUNAN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	51006	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	B51006-01 HFP	OTHER	CA	DELTA DENTAL OF CALIFORNI
2	G93428-01	OTHER	CA	DENTI-CAL

General Provider Information

NPI Number	:	1073559464
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SELMA YOUSIF YOUNAN DDS

Provider Business Mailing Address
First Line	:	312 HIGHLAND AVE
Second Line	:	STE. 102
City	:	EL CAJON
State	:	CA
Zip	:	92020-5218
Country	:	US
Telephone Number	:	619-440-0866
Fax Number	:	619-440-0817

Provider Business Practice Location Address
First Line	:	312 HIGHLAND AVE
Second Line	:	STE. 102
City	:	EL CAJON
State	:	CA
Zip	:	92020-5218
Country	:	US
Telephone Number	:	619-440-0866
Fax Number	:	619-440-0817

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	05/13/2021

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Directions to “ SELMA YOUSIF YOUNAN DDS” Practice Location

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