Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Individual
TADELE DEMISSE
Active
Individual
TADELE DEMISSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
061697
NY
1223G0001X
General Practice Dentistry
Primary
DS043969
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02995513
—
NY
05
—
10000017080506
—
PA
01
—
331833
OSCAR
NY
01
—
53099A
PIN
NY
Enumeration date
05/13/2019
Last updated
12/28/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up