Provider Demographics
NPI:1023823077
Name:YOUNIS, YOUNIS IMAD (RDHAP)
Entity type:Individual
Prefix:
First Name:YOUNIS
Middle Name:IMAD
Last Name:YOUNIS
Suffix:
Gender:M
Credentials:RDHAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12112 KUHNER WAY
Mailing Address - Street 2:
Mailing Address - City:LAKESIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92040-1763
Mailing Address - Country:US
Mailing Address - Phone:708-830-3762
Mailing Address - Fax:
Practice Address - Street 1:12112 KUHNER WAY
Practice Address - Street 2:
Practice Address - City:LAKESIDE
Practice Address - State:CA
Practice Address - Zip Code:92040-1763
Practice Address - Country:US
Practice Address - Phone:708-830-3762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1133124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist