Individual provider Active NPI

Yousuf Al-Aboosi, DDS, MS

  • Periodontics
  • Annandale, VA
National Provider Identifier
1306299185
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
0401417005 Issued in VA
Practice address
7617 Little River Tpke Ste 910
Annandale, VA 22003-2618
Phone
(703) 462-9092
Fax
(703) 256-7722
NPI assigned
Jul 18, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 0401417005 VA Primary

Addresses

Primary practice location

7617 Little River Tpke Ste 910
Annandale, VA 22003-2618

Mailing address

7617 Little River Tpke Ste 910
Annandale, VA 22003-2618
Phone (703) 462-9092

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20170422000239 AL Order and Referring Only - DentistPractitioner - Dentist 4082990288

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0401417005VAMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Yousuf Al-Aboosi DDS LLC Periodontics Current Accepting new patients
Focus Dental Specialists Periodontics CurrentSince Sep 23, 2021 Accepting new patients

Locations

7617 Little River Tpke
Ste 910
Annandale, VA 22003
Phone (703) 462-9092

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1468800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1306299185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7617 LITTLE RIVER TPKE STE 910",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220032618",
            "telephone_number": "703-462-9092",
            "fax_number": "703-256-7722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7617 LITTLE RIVER TPKE STE 910",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220032618",
            "telephone_number": "703-462-9092",
            "fax_number": "703-256-7722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL-ABOOSI",
        "first_name": "YOUSUF",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-18",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "VA",
            "license": "0401417005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annandale, VA

Sources for this page

Verify at the official NPI Registry.