Mina Yacoub

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS042848 Issued in PA

Practice address

1646 W Chester Pike Ste 1
West Chester, PA 19382-7979

Phone

(610) 590-4568

NPI assigned

Mar 30, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• M.Y. Family Dentistry

  • General Practice Dentistry
  • West Chester, PA
  • NPI 1407743024
  NPD Authorized official

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

{
    "created_epoch": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632009600000",
    "number": "1245868777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1646 W CHESTER PIKE STE 1",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193827979",
            "telephone_number": "610-590-4568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1646 W CHESTER PIKE STE 1",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193827979",
            "telephone_number": "610-590-4568"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 Old York Rd",
            "address_purpose": "LOCATION",
            "city": "Abington",
            "state": "PA",
            "postal_code": "190013788",
            "country_code": "US",
            "telephone_number": "215-481-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YACOUB",
        "first_name": "MINA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-30",
        "last_updated": "2021-09-19",
        "certification_date": "2021-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS042848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Wright
• David Paul Wrzesniewski, RPH
• David H Wu, M.D.
• Gabrielle Monique Wykle, OTR
• Wyllpen Wellness Collective LLC
• Anthony M Yanarella, CRNA
• Ming-Lung Yang, DMD
• Tianna Rachel Yanoscak
• Zheng Yao
• Emily Yatsko

• General Practice Dentistry in West Chester, PA
• Providers in West Chester, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.