Active NPI
Youssef Hanna Youssef, DDS
- Student in an Organized Health Care Education/Training Program
- New York, NY
National Provider Identifier
1508486614
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 2165 Broadway
New York, NY 10024-6603 - Phone
- (646) 809-7511
- NPI assigned
- Apr 18, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 22DI02836300 | NJ | |
| General Practice Dentistry | 1223G0001X | DN25740 | FL | |
| General Practice Dentistry | 1223G0001X | 062239-01 | NY | |
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
2165 Broadway
New York, NY 10024-6603
Mailing address
15 Leonello LN
Staten Island, NY 10307-2412
Phone (727) 331-4165
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN25740 | FL | MD | General Practice Dentistry |
| 22DI02836300 | NJ | MD | General Practice Dentistry |
| 062239-01 | NY | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Simple Dental, PLLC | General Practice | Current | Accepting new patients |
Locations
2165 Broadway
New York, NY 10024
Phone (212) 877-2980
Organizations & group practices 1
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": "1587168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670889600000",
"number": "1508486614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 LEONELLO LN",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103072412",
"telephone_number": "727-331-4165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2165 BROADWAY",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100246603",
"telephone_number": "646-809-7511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUSSEF",
"first_name": "YOUSSEF",
"middle_name": "HANNA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-04-18",
"last_updated": "2022-12-13",
"certification_date": "2022-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NJ",
"license": "22DI02836300",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN25740",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "062239-01",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.