Provider Demographics
NPI:1194784652
Name:DAVID YOUSSEFI DMD INC
Entity type:Organization
Organization Name:DAVID YOUSSEFI DMD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUSSEFI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-378-7677
Mailing Address - Street 1:4616 WILLIS AVE
Mailing Address - Street 2:#206
Mailing Address - City:SHERMAN OAKES
Mailing Address - State:CA
Mailing Address - Zip Code:91403
Mailing Address - Country:US
Mailing Address - Phone:818-378-7677
Mailing Address - Fax:
Practice Address - Street 1:4616 WILLIS AVE
Practice Address - Street 2:#206
Practice Address - City:SHERMAN OAKES
Practice Address - State:CA
Practice Address - Zip Code:91403
Practice Address - Country:US
Practice Address - Phone:818-378-7677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-22
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45066122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty