Active NPI
Abel Hailay Kebede
- General Practice Dentistry
- Takoma Park, MD
National Provider Identifier
1780430967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 18098
- Practice address
- 1147 University Blvd E
Takoma Park, MD 20912-7444 - Phone
- (703) 520-9063
- NPI assigned
- Apr 29, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 18098 | MD | Primary |
Addresses
Primary practice location
1147 University Blvd E
Takoma Park, MD 20912-7444
Mailing address
3424 Canberra St
Silver Spring, MD 20904-1705
Phone (301) 520-5742
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18098 | MD | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1714348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719446400000",
"number": "1780430967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3424 CANBERRA ST",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209041705",
"telephone_number": "301-520-5742"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1147 UNIVERSITY BLVD E",
"city": "TAKOMA PARK",
"state": "MD",
"postal_code": "209127444",
"telephone_number": "703-520-9063"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEBEDE",
"first_name": "ABEL",
"middle_name": "HAILAY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-04-29",
"last_updated": "2024-06-27",
"certification_date": "2024-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MD",
"license": "18098",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Takoma Park, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.