Individual provider Active NPI

Youssef Hanna Youssef, DDS

  • Student in an Organized Health Care Education/Training Program
  • New York, NY
National Provider Identifier
1508486614
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
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

Updated by the provider on Dec 13, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
DN25740FLMDGeneral Practice Dentistry
22DI02836300NJMDGeneral Practice Dentistry
062239-01NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Simple Dental, PLLC General Practice CurrentSince Dec 18, 2022 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.

Verify at the official NPI Registry.