Individual provider Active NPI

Joseph Youssef Atme, DDS

  • Dentist
  • Plymouth, MN
National Provider Identifier
1023397429
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D12021 Issued in MN
Practice address
15650 36TH Ave N
#150
Plymouth, MN 55446
Phone
(763) 557-0287
Fax
(763) 557-0295
NPI assigned
Aug 16, 2011
Last updated
Jun 19, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D12021 MN Primary

Addresses

Primary practice location

15650 36TH Ave N
#150
Plymouth, MN 55446

Mailing address

15650 36TH Ave N
#150
Plymouth, MN 55446
Phone (763) 557-0287

Other names 1

  • Yousef Abou Atme Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20160602000828 MN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7810287943

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D12021MNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Northland Smiles Corporation PA Past Accepting new patients
Deerwood Dental, Inc Past Accepting new patients

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": "1313452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1023397429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15650 36TH AVE N",
            "address_2": "#150",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "55446",
            "telephone_number": "763-557-0287",
            "fax_number": "763-557-0295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15650 36TH AVE N",
            "address_2": "#150",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "55446",
            "telephone_number": "763-557-0287",
            "fax_number": "763-557-0295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATME",
        "first_name": "JOSEPH",
        "middle_name": "YOUSSEF",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-16",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D12021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YOUSEF",
            "last_name": "ABOU ATME",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Plymouth, MN

Sources for this page

Verify at the official NPI Registry.