Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1114927100 Deactivated / Inactive NPI Male Practitioner

Dr. Khalid M Yacoub , DDS

Dentist - General Practice • El Cajon, CA

✓ Accepts Medicare Assignment
⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Khalid Yacoub has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 30, 2005
NPI Deactivation Date March 22, 2006
Total Practice Duration ~29 Years of Practice (1977 – 2006)

Professional Overview & Biography Verified Profile Summary

Dr. Khalid Yacoub, DDS was a registered Dentist - General Practice practicing in El Cajon, CA. Throughout an active medical career spanning 29 years, Dr. Yacoub provided care at the practice location at 1008 E WASHINGTON AVE until profile deactivation on 2006-03-22.

Dr. Yacoub accepted Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

1008 E Washington Ave

El Cajon, CA 920206614

Telephone 6193341468
Fax 6193284035
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Other

Graduation Year

1977

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in El Cajon, CA

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
49 Yrs Matches City Avg
City Avg: 49.0 Yrs
State Avg: 21.7 Yrs
Regional Practice Density
69 Specialists

Practicing in El Cajon, CA (18734 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Yacoub (49 Years) 49 Yrs
El Cajon Specialty Average (49.0 Years) 49.0 Yrs

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License CA 43510

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Dentical
G92696-01 (CA)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
📍
Updated Practice Location July 08, 2007

Registered at 1008 E WASHINGTON AVE, EL CAJON, CA 920206614 (Tel: 6193341468)

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Updated Business Mailing Address July 08, 2007

Registered at 1008 E WASHINGTON AVE, EL CAJON, CA 920206614 (Tel: 6193341468)

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Provider Name / Credentials Updated July 08, 2007

Recorded as KHALID YACOUB, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #43510 in CA)

🔄
NPI Profile Reactivated March 28, 2006

Record officially reactivated for active practice on March 28, 2006

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NPI Profile Deactivated March 22, 2006

Record deactivated on March 22, 2006

🟢
Initial NPI Registration & Enumeration July 30, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1114927100
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 30, 2005
Last Update: July 08, 2007
Deactivation Date: March 22, 2006
Sole Proprietor: Yes

Mailing Address

1008 E Washington Ave

El Cajon, CA 920206614

Phone: 6193341468

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.