Healthcare Provider Details

I. General information

NPI: 1982625547
Provider Name (Legal Business Name): DAVID B. ETTINGER M.D. D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 E CHESTNUT HILL RD
NEWARK DE
19713-4043
US

IV. Provider business mailing address

131 E CHESTNUT HILL RD
NEWARK DE
19713-4043
US

V. Phone/Fax

Practice location:
  • Phone: 302-369-1000
  • Fax: 302-369-6016
Mailing address:
  • Phone: 302-369-1000
  • Fax: 302-369-6016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberG1-0001099
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License NumberC1-0005329
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: