Individual
DR. MULUALEM TESFAYE ASSEFA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5570 SILVER HILL RD, DISTRICT HEIGHTS, MD 20747-1104
(301) 202-2222
Mailing address
5622 COLUMBIA PIKE, SUIT 103, FALLS CHURCH, VA 22041-2718
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
16016
MD
1223G0001X
General Practice Dentistry
0401415215
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DEN1001790
DC DENTAL BOARD
DC
01
—
MD16016
MARYLAND DENTAL BOARD
MD
Enumeration date
06/19/2015
Last updated
10/08/2020
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