Provider Demographics
NPI:1306299185
Name:AL-ABOOSI, YOUSUF (DDS, MS)
Entity type:Individual
Prefix:
First Name:YOUSUF
Middle Name:
Last Name:AL-ABOOSI
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7617 LITTLE RIVER TPKE STE 910
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-2618
Mailing Address - Country:US
Mailing Address - Phone:703-462-9092
Mailing Address - Fax:703-256-7722
Practice Address - Street 1:7617 LITTLE RIVER TPKE STE 910
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-2618
Practice Address - Country:US
Practice Address - Phone:703-462-9092
Practice Address - Fax:703-256-7722
Is Sole Proprietor?:No
Enumeration Date:2016-07-18
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014170051223P0300X
AL63451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Yes1223P0300XDental ProvidersDentistPeriodontics