Individual provider Active NPI

Youssef Dabbagh

  • Dentist
  • Granada Hills, CA
National Provider Identifier
1821855503
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
109878 Issued in CA
Practice address
11026 Balboa Blvd
Granada Hills, CA 91344-5007
Phone
(818) 363-1211
NPI assigned
Feb 29, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 109878 CA Primary

Addresses

Primary practice location

11026 Balboa Blvd
Granada Hills, CA 91344-5007

Mailing address

17570 Rinaldi St
Granada Hills, CA 91344-3318
Phone (818) 447-1372

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
109878CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Youssef a Dabbagh DDS Inc CurrentSince Mar 3, 2024 Accepting new patients

Locations

11026 Balboa Blvd
Granada Hills, CA 91344
Phone (818) 363-1211

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": "1709164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1821855503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17570 RINALDI ST",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913443318",
            "telephone_number": "818-447-1372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11026 BALBOA BLVD",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913445007",
            "telephone_number": "818-363-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DABBAGH",
        "first_name": "YOUSSEF",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-02-29",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "109878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granada Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; 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.