NPIMap

Dereje Legesse Bereded, DDS

Individual provider Active NPI General Practice Dentistry · Washington, DC

NPI 1265415251 · NPPES record last updated Jun 10, 2016

Key facts

NPI
1265415251
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
1000305 (DC)
Practice address
2837 Alabama Ave SE
Washington, DC 20020
Phone
(202) 581-7600
Fax
(202) 581-7061
NPI assigned
Nov 22, 2005
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1000305DCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dereje Bereded DDS,LLC General Practice Current Accepting new patients
Good Hope Family Dental General Practice Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1000305 DC Yes

Addresses

Primary practice location

2837 Alabama Ave SE
Washington, DC 20020

Mailing address

2837 Alabama Ave SE
Washington, DC 20020
Phone (202) 581-7600

Other providers in Washington, DC

All providers in Washington, DC · General Practice Dentistry in District of Columbia

Sources for this page

Verify at the official NPI Registry.