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General NPI Number Information
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NPI Number | 1861028896
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Entity Type | Individual
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Provider Name | RAKEB A TILAHUN DDS
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Gender | Female
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Dates
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Enumeration Date | 03/21/2020
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Last Update Date | 03/21/2020
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Provider Practice Location Address
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Address Line | 2837 ALABAMA AVE SE
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City | WASHINGTON
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State | DC
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Zip | 20020-3000
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Country | US
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Telephone | 202-581-7600
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Fax |
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Provider Business Mailing Address
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Address Line | 8811 ROYAL DOULTON LN
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City | FAIRFAX
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State | VA
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Zip | 22031-2179
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Country | US
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Telephone | 240-478-4487
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DEN1001924
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 0401416244
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License Number State | VA
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