Firas Ghattas Yacoub, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30-024026 Issued in OH

Practice address

9519 State Route 14
Streetsboro, OH 44241-5227

Phone

(330) 423-6779

NPI assigned

Aug 9, 2011

Last updated

Aug 6, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1312848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1245519214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9519 STATE ROUTE 14",
            "city": "STREETSBORO",
            "state": "OH",
            "postal_code": "442415227",
            "telephone_number": "216-778-4737",
            "fax_number": "216-778-8046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9519 STATE ROUTE 14",
            "city": "STREETSBORO",
            "state": "OH",
            "postal_code": "442415227",
            "telephone_number": "330-423-6779"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 Metrohealth Dr",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441091900",
            "country_code": "US",
            "telephone_number": "216-778-7800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YACOUB",
        "first_name": "FIRAS",
        "middle_name": "GHATTAS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-09",
        "last_updated": "2021-08-06",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-024026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142703",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandria A Willis
• Rachel Wolf
• Louisa Campitelli Wolowiecki, PHARMD, RPH
• Hugh Wonderly
• Eileen Hai Huat Wong, M.D.
• Sabina Zarlenga, LPCC

• General Practice Dentistry in Streetsboro, OH
• Providers in Streetsboro, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.