Healthcare Provider Details
I. General information
NPI: 1184572794
Provider Name (Legal Business Name): NEXUS DENTAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/19/2026
Last Update Date: 03/19/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1313 SOUTHERN AVE SE
OXON HILL MD
20745
US
IV. Provider business mailing address
1313 SOUTHERN AVE SOUTHEAST
OXON HILL MD
20745
US
V. Phone/Fax
- Phone: 703-786-1413
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MULUALEM
ASSEFA
Title or Position: OWNER/DENTIST
Credential: DDS
Phone: 703-786-1413