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Contact Information

ABYSSINIA DENTAL LLC
4041 POWDER MILL RD STE 100
BELTSVILLE, MD20705-3106
 Phone: 301-477-1005
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for ABYSSINIA DENTAL LLC

NPI # 1851861199
LBN Legal business name ABYSSINIA DENTAL LLC
Authorized official DEREJEW TESSEMA - (DENTIST)
Entity Organization
Organization subpart 1 No
Enumeration date 11/29/2018
Last updated 11/29/2018 - About 8 years ago
Identifiers
DC Medicaid 17075979
MD Medicaid 131458100
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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