Individual provider Active NPI

George Sobhy Youssef

  • General Practice Dentistry
  • Cedar Rapids, IA
National Provider Identifier
1811425317
Registry record updated May 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DDS-09392 Issued in IA
Practice address
2315 Edgewood Rd SW Unit 160
Cedar Rapids, IA 52404-3391
Phone
(319) 423-8637
NPI assigned
May 27, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DDS-09392 IA Primary

Addresses

Primary practice location

2315 Edgewood Rd SW Unit 160
Cedar Rapids, IA 52404-3391

Mailing address

2163 W Bowler St
Chicago, IL 60612-4201
Phone (978) 614-5937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20170817003741 IA Order and Referring Only - DentistPractitioner - Dentist 5294007704

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DDS-09392IAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1495843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495843200000",
    "number": "1811425317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2163 W BOWLER ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124201",
            "telephone_number": "978-614-5937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 EDGEWOOD RD SW UNIT 160",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524043391",
            "telephone_number": "319-423-8637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUSSEF",
        "first_name": "GEORGE",
        "middle_name": "SOBHY",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-27",
        "last_updated": "2017-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "DDS-09392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

Verify at the official NPI Registry.