Individual provider Active NPI

Omar Mohammed Yousuf, D.D.S.

  • General Practice Dentistry
  • Plano, TX
National Provider Identifier
1023371945
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
27898 Issued in TX
Practice address
5940 W Parker Rd Ste 103
Plano, TX 75093-6404
Phone
(214) 619-6329
NPI assigned
Jun 18, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6292 LA
General Practice Dentistry 1223G0001X 27898 TX Primary

Addresses

Primary practice location

5940 W Parker Rd Ste 103
Plano, TX 75093-6404

Mailing address

5940 W Parker Rd Ste 103
Plano, TX 75093-6404
Phone (214) 619-6329

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250114003993 TX Practitioner - DentistPractitioner - Oral Surgery 0648708933

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6292LAMDProfessional Counselor
27898TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Innovation of Plano CurrentSince Dec 11, 2024 Accepting new patients
Radiant Family Dental PLLC General Practice Current Accepting new patients

Locations

5940 W Parker Rd
Ste 103
Plano, TX 75093
Phone (214) 619-6329

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1339977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1023371945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5940 W PARKER RD STE 103",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750936404",
            "telephone_number": "214-619-6329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5940 W PARKER RD STE 103",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750936404",
            "telephone_number": "214-619-6329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUSUF",
        "first_name": "OMAR",
        "middle_name": "MOHAMMED",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-18",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "6292",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "27898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.