Provider Demographics
NPI:1093042111
Name:ASSEMU, SILESHI B (DDS)
Entity Type:Individual
Prefix:DR
First Name:SILESHI
Middle Name:B
Last Name:ASSEMU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2115 KRAMER LN
Mailing Address - Street 2:SUITE 100
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-4013
Mailing Address - Country:US
Mailing Address - Phone:512-978-9000
Mailing Address - Fax:
Practice Address - Street 1:15 WALLER ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-5240
Practice Address - Country:US
Practice Address - Phone:512-978-9895
Practice Address - Fax:512-978-9900
Is Sole Proprietor?:No
Enumeration Date:2009-11-10
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014126781223G0001X
TX263841223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health
No1223G0001XDental ProvidersDentistGeneral Practice