Active NPI
Passant Youssef Ibrahim, DDS
- Dentist
- El Monte, CA
National Provider Identifier
1346026911
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 109300
- Practice address
- 11920 Garvey Ave
El Monte, CA 91732-3514 - Phone
- (626) 988-6583
- NPI assigned
- Sep 7, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 109300 | CA | Primary |
Addresses
Primary practice location
11920 Garvey Ave
El Monte, CA 91732-3514
Mailing address
15785 Approach Ave
Chino, CA 91708-7654
Phone (626) 665-6816
Other practice location 1
15785 Approach Ave
Chino, CA 91708-7654
Phone (626) 665-6816
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250812001556 | CA | Order and Referring Only - Dentist | 5991203655 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 109300 | CA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699660800000",
"number": "1346026911",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15785 APPROACH AVE",
"city": "CHINO",
"state": "CA",
"postal_code": "917087654",
"telephone_number": "626-665-6816"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11920 GARVEY AVE",
"city": "EL MONTE",
"state": "CA",
"postal_code": "917323514",
"telephone_number": "626-988-6583"
}
],
"practiceLocations": [
{
"address_1": "15785 Approach Ave",
"address_purpose": "LOCATION",
"city": "Chino",
"state": "CA",
"postal_code": "917087654",
"country_code": "US",
"telephone_number": "626-665-6816",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "IBRAHIM",
"first_name": "PASSANT",
"middle_name": "YOUSSEF",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-09-07",
"last_updated": "2023-11-11",
"certification_date": "2023-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "109300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Monte, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2023; 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.