Provider Demographics
NPI:1699530840
Name:ABU AL SOOF, YOUSIF (DDS)
Entity type:Individual
Prefix:DR
First Name:YOUSIF
Middle Name:
Last Name:ABU AL SOOF
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:266 MCGINNIS CRESCENT
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:L9T0N7
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:103 W DOMINICK ST STE 20
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:NY
Practice Address - Zip Code:13440-5809
Practice Address - Country:US
Practice Address - Phone:213-410-7986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-16
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY064798122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program