Individual provider Active NPI

Biniam Tsegay

  • General Practice Dentistry
  • Atlanta, GA
National Provider Identifier
1912347154
Registry record updated May 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN015329 Issued in GA
Practice address
2484 Briarcliff Rd NE Ste 29
Atlanta, GA 30329-3011
Phone
(404) 315-7375
NPI assigned
Jul 2, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN015329 GA
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X DN015329 GA Primary

Addresses

Primary practice location

2484 Briarcliff Rd NE Ste 29
Atlanta, GA 30329-3011

Mailing address

944 21St Ave N Apt 407
Nashville, TN 37208-3449

Other practice location 1

4805 Briarc Rd NE
Atlanta, GA 30345-2767
Phone (407) 580-9990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20181211000219 GA Order and Referring Only - DentistPractitioner - Dentist 7315281888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN015329GAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1372723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557273600000",
    "number": "1912347154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "944 21ST AVE N APT 407",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372083449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2484 BRIARCLIFF RD NE STE 29",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303293011",
            "telephone_number": "404-315-7375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4805 Briarc Rd NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303452767",
            "country_code": "US",
            "telephone_number": "407-580-9990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TSEGAY",
        "first_name": "BINIAM",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-02",
        "last_updated": "2019-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN015329",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN015329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.