Amy Berhanu Demissie DDS PC
Organization Active NPI Dentist · Banning, CA
NPI 1215009246 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1215009246
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dentist 122300000X
- License
- 30174 (CA)
- Legal business name
- AMY BERHANU DEMISSIE DDS PC
- Practice address
- 471 N San Gorgonio Ave
Banning, CA 92220 - Phone
- (951) 849-2888
- Fax
- (951) 849-1454
- NPI assigned
- Nov 14, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Amsale Berhanu Demissie
- Title
- President
- Phone
- (951) 849-2888
Practitioners 3
-
Amsale Berhanu-Demissie, DDS.
-
Jale Berhanu, DDS.
-
David Demissie, DDS
National Provider Directory
Locations
471 N San Gorgonio Ave
Banning, CA 92220
Phone (951) 849-2888
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | 30174 | CA | Yes |
Addresses
Primary practice location
471 N San Gorgonio Ave
Banning, CA 92220
Mailing address
471 N San Gorgonio Ave
Banning, CA 92220
Phone (951) 849-2888
Other providers in Banning, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.