Dereje Bereded DDS,LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DEREJE BEREDED DDS,LLC

Practice address

803 Southern Ave
Oxon Hill, MD 20745-3462

Phone

(301) 505-2550

Fax

(301) 505-6676

NPI assigned

Aug 9, 2011

Last updated

Jul 5, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Dereje BerededNPI 1265415251

Title

Manager

Phone

(301) 505-2550

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dereje Legesse Bereded, DDS

  • General Practice Dentistry
  • Washington, DC
  • NPI 1265415251
  NPD Authorized official

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

{
    "created_epoch": "1312848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562284800000",
    "number": "1821377755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 SOUTHERN AVE",
            "city": "OXON HILL",
            "state": "MD",
            "postal_code": "207453462",
            "telephone_number": "301-505-2550",
            "fax_number": "301-505-6676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 SOUTHERN AVE",
            "city": "OXON HILL",
            "state": "MD",
            "postal_code": "207453462",
            "telephone_number": "301-505-2550",
            "fax_number": "301-505-6676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEREJE BEREDED DDS,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-09",
        "last_updated": "2019-07-05",
        "status": "A",
        "authorized_official_last_name": "BEREDED",
        "authorized_official_first_name": "DEREJE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "301-505-2550",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cherry Delahay, CRNP-PMH
• Linnie Aragon Delmonte, MD
• Dental Glitters LLC
• Dental One Associates Oxon Hill PC
• Dentistry for Children of Maryland, LLC
• Kenneth Andre Desandies, MD
• Mytaya M Deville
• Shawnessa Millicent Devonish, MA, LGPC, NCC
• Dialysis Newco LLC (U.S. Renal Care Oxon Hills Dialysis)
• Diasporic Healing LLC

• 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 5, 2019; 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.