Addisalem Teklu

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

18287 Issued in MD

Practice address

30 Audrey LN Ste a
Oxon Hill, MD 20745-1301

Phone

(301) 567-5437

NPI assigned

May 1, 2024

Last updated

Jul 9, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Oxon Hill Smiles Youth Dentistry, PC

  • General Practice Dentistry
  • Oxon Hill, MD
  • NPI 1861685554
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1714521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1578310371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 AUDREY LN",
            "city": "OXON HILL",
            "state": "MD",
            "postal_code": "207451301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 AUDREY LN STE A",
            "city": "OXON HILL",
            "state": "MD",
            "postal_code": "207451301",
            "telephone_number": "301-567-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEKLU",
        "first_name": "ADDISALEM",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-01",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "18287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amicia M Sykes
• Virnequa Sykes, COTA
• Tamah, LLC
• Tanek L. Jenkins, DDS (ABC Dentistry)
• Paulette Tchenang
• The Agape Health Group, Inc (Agape Health and Life Solutions)
• The Behavioral Intervention Rehabilitation and Development Project LLC (The B.I.R.D. Project)
• The Dental Group of Fort Washington
• The Pathfinder Project Inc
• Alycia Thompson, LMSW

• General Practice Dentistry in Oxon Hill, MD
• Providers in Oxon Hill, MD by specialty
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.