Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

WONGELAWIT DELDIL TADESSE DDS
NPI 1487359717
Dentist - General Practice in Jbsa Lackland, TX

Active since April 04, 2023
2133 PEPPERRELL ST BLDG 3352, JBSA LACKLAND, TX 78236(210) 292-0774 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 13, 2026, Jul 23, 2024, Jul 25, 2023 and 1 more (4 updates tracked since 2023).

About Wongelawit Deldil Tadesse Dds NPPES

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

WONGELAWIT DELDIL TADESSE DDS (NPI 1487359717) is an individual general practice provider in Jbsa Lackland, Texas, licensed in Utah (134917919926) and active in the NPI registry since April 2023.

NPPES Registry Identity

NPI1487359717
Entity TypeIndividualFemale
Primary Taxonomy1223G0001X
Provider Legal NameWONGELAWIT DELDIL TADESSECredential: DDS
Location Address2133 PEPPERRELL ST BLDG 3352Jbsa Lackland, TX 78236-5313
Mailing Address2133 Pepperrell St Bldg 3352Jbsa Lackland, TX 78236-5313
Sole ProprietorYes
Enumeration DateApril 4, 2023
Last NPPES UpdateJuly 13, 20264 updates tracked since enumeration
NPPES CertifiedJuly 13, 2026
NPI 1487359717 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License Licensed in UT · 134917919926
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.

2133 PEPPERRELL ST BLDG 3352, Jbsa Lackland, TX 78236

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dentist (Orthodontics and Dentofacial Orthopedics)
2133 PEPPERRELL ST BLDG 3352
JBSA LACKLAND, TX 78236
Dentist
2133 PEPPERRELL ST BLDG 3352, 2133 PEPPERRELL STREET, BUILDING 3352
JBSA LACKLAND, TX 78236
Dentist (Orthodontics and Dentofacial Orthopedics)
2133 PEPPERRELL ST BLDG 3352
JBSA LACKLAND, TX 78236
Dentist (General Practice)
2133 PEPPERRELL ST BLDG 3352
JBSA LACKLAND, TX 78236
Dentist (General Practice)
2133 PEPPERRELL ST BLDG 3352
JBSA LACKLAND, TX 78236
Dentist
2133 PEPPERRELL ST BLDG 3352
JBSA LACKLAND, TX 78236
Student in an Organized Health Care Education/Training Program
2133 PEPPERRELL ST BLDG 3352
JBSA LACKLAND, TX 78236
Dentist
2133 PEPPERRELL ST BLDG 3352
JBSA LACKLAND, TX 78236

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 Wongelawit Tadesse's NPI number?

The NPI number for Wongelawit Tadesse is 1487359717. It was assigned to this individual provider in the NPPES registry on April 4, 2023.

Where is Wongelawit Tadesse located?

Wongelawit Tadesse practices at 2133 Pepperrell St Bldg 3352, Jbsa Lackland, TX 78236. The listed phone number is (210) 292-0774.

What is Wongelawit Tadesse'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 Wongelawit Tadesse was last updated on July 13, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.