Provider Demographics
NPI:1043306814
Name:ABEBE, TEGEST G (DMD)
Entity Type:Individual
Prefix:DR
First Name:TEGEST
Middle Name:G
Last Name:ABEBE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 18TH ST. NW
Mailing Address - Street 2:SUITE # 206
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036
Mailing Address - Country:US
Mailing Address - Phone:202-331-0444
Mailing Address - Fax:202-331-8980
Practice Address - Street 1:1325 18TH ST. NW
Practice Address - Street 2:SUITE # 206
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036
Practice Address - Country:US
Practice Address - Phone:202-331-0444
Practice Address - Fax:202-331-8980
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN5121122300000X, 1223G0001X
VA0401417896122300000X, 1223G0001X
TX14838122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice