Provider Demographics
NPI:1992323315
Name:MOHAMED, YOUNIS (DDS)
Entity type:Individual
Prefix:DR
First Name:YOUNIS
Middle Name:
Last Name:MOHAMED
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2881 SALINA ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48120-1554
Mailing Address - Country:US
Mailing Address - Phone:313-699-0275
Mailing Address - Fax:
Practice Address - Street 1:9550 DIX STE D
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48120-1529
Practice Address - Country:US
Practice Address - Phone:313-438-5158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-13
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29016006181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice