Individual provider Active NPI

Elsabet Tekle, DDS LLC

  • General Practice Dentistry
  • Silver Spring, MD
National Provider Identifier
1730217639
Registry record updated Jan 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11959 Issued in MD
Practice address
2415 Musgrove Rd Ste 309
Silver Spring, MD 20904-5223
Phone
(301) 384-7800
Fax
(301) 384-5666
NPI assigned
Mar 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 11959 MD Primary

Addresses

Primary practice location

2415 Musgrove Rd Ste 309
Silver Spring, MD 20904-5223

Mailing address

2415 Musgrove Rd Ste 309
Silver Spring, MD 20904-5223
Phone (301) 384-7800

Other names 1

  • Elsabet Tekle Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150924000130 MD Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2466674197

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11959MDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Elsabet Tekle DDS LLC General Practice CurrentSince Nov 19, 2023 Accepting new patients
Elsabet Tekle DDS LLC CurrentSince Jan 5, 2009 Accepting new patients

Locations

2415 Musgrove Rd
Ste 309
Silver Spring, MD 20904
Phone (301) 384-7800

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.

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421020800000",
    "number": "1730217639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 MUSGROVE RD STE 309",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209045223",
            "telephone_number": "301-384-7800",
            "fax_number": "301-384-5666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 MUSGROVE RD STE 309",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209045223",
            "telephone_number": "301-384-7800",
            "fax_number": "301-384-5666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEKLE",
        "first_name": "ELSABET",
        "credential": "DDS LLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2015-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "11959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELSABET",
            "last_name": "TEKLE",
            "credential": "DDS LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Silver Spring, MD

Sources for this page

Verify at the official NPI Registry.