DAVID DEMISSIE DDS
NPI 1154812709
Dentist - General Practice in San Bernardino, CA

Q: What is David Demissie's NPI number?

The NPI number for David Demissie is 1154812709. It was assigned to this individual provider in the NPPES registry on May 18, 2018.

Q: What is David Demissie's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for David Demissie was last updated on April 27, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 18, 2018

1781 N WATERMAN AVE, SAN BERNARDINO, CA 92404(909) 882-4988 Get Directions Write a Review

NPPES record last updated: April 27, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 27, 2021, May 18, 2018 (2 updates tracked since 2018).

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About David Demissie Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DAVID DEMISSIE DDS (NPI 1154812709) is an individual general practice provider in San Bernardino, California, licensed in California (DDS104225) and active in the NPI registry since May 2018. He maintains a secondary practice location in Banning.

NPPES Registry Identity

NPI1154812709

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameDAVID DEMISSIECredential: DDS

Location Address1781 N WATERMAN AVESan Bernardino, CA 92404-5114

Mailing Address471 N San Gorgonio AveBanning, CA 92220-5523

Phone(909) 882-4988

Sole ProprietorNo

Enumeration DateMay 18, 2018

Last NPPES UpdateApril 27, 20212 updates tracked since enumeration

NPPES CertifiedApril 27, 2021

✔ NPI 1154812709 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in CA · DDS104225

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

1781 N WATERMAN AVE, San Bernardino, CA 92404

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Secondary Practice Location 1

Location 1471 N San Gorgonio AveBanning, CA 92220-5523 · Phone (951) 849-2888

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is David Demissie's NPI number?

The NPI number for David Demissie is 1154812709. It was assigned to this individual provider in the NPPES registry on May 18, 2018.

Where is David Demissie located?

David Demissie practices at 1781 N Waterman Ave, San Bernardino, CA 92404. The listed phone number is (909) 882-4988.

What is David Demissie's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for David Demissie was last updated on April 27, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.