Active NPI
Carol Yacoub, DDS
- General Practice Dentistry
- Leesburg, VA
National Provider Identifier
1811549272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 0401416847
- Practice address
- 1614 Village Market Blvd SE Ste 100
Leesburg, VA 20175-5113 - Phone
- (703) 777-8777
- NPI assigned
- Jul 15, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 0401416847 | VA | Primary |
Addresses
Primary practice location
1614 Village Market Blvd SE Ste 100
Leesburg, VA 20175-5113
Mailing address
16334 Hunter PL
Leesburg, VA 20176-7829
Phone (614) 288-3979
Other practice location 1
50 Irving St NW
Washington, DC 20422-0001
Phone (202) 745-8000
Other practice location 2
2270 Valor Dr
Winchester, VA 22601-3699
Phone (540) 545-7878
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | cyacoub@leesburgfamilysmiles.com |
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 |
|---|---|---|---|
| 0401416847 | VA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649289600000",
"number": "1811549272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16334 HUNTER PL",
"city": "LEESBURG",
"state": "VA",
"postal_code": "201767829",
"telephone_number": "614-288-3979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1614 VILLAGE MARKET BLVD SE STE 100",
"city": "LEESBURG",
"state": "VA",
"postal_code": "201755113",
"telephone_number": "703-777-8777"
}
],
"practiceLocations": [
{
"address_1": "50 Irving St NW",
"address_purpose": "LOCATION",
"city": "Washington",
"state": "DC",
"postal_code": "204220001",
"country_code": "US",
"telephone_number": "202-745-8000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2270 Valor Dr",
"address_purpose": "LOCATION",
"city": "Winchester",
"state": "VA",
"postal_code": "226013699",
"country_code": "US",
"telephone_number": "540-545-7878",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "YACOUB",
"first_name": "CAROL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-15",
"last_updated": "2022-04-07",
"certification_date": "2022-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "VA",
"license": "0401416847",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "cyacoub@leesburgfamilysmiles.com",
"affiliation": "N",
"address_1": "1614 Village Market Blvd SE Ste 100",
"city": "Leesburg",
"state": "VA",
"country_code": "US",
"postal_code": "201755113",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Leesburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.