Healthcare Provider Details

I. General information

NPI: 1043306814
Provider Name (Legal Business Name): TEGEST G ABEBE DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3912 GEORGIA AVE NW
WASHINGTON DC
20011-5861
US

IV. Provider business mailing address

2333 ONTARIO RD NW
WASHINGTON DC
20009-2627
US

V. Phone/Fax

Practice location:
  • Phone: 844-796-2797
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number14838
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number17674
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number0401417896
License Number StateVA
# 4
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDEN5121
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: