DR. TIBEBU MEKONNEN TSEGGA D.D.S.
NPI 1528149358
Dentist - Oral and Maxillofacial Surgery in Jbsa Lackland, TX

Active since October 18, 2006Opted out of Medicare · through Jul 30, 2026
1100 WILFORD HALL LOOP BLDG 4554, JBSA LACKLAND, TX 78236(615) 668-3322 Get Directions Write a Review

NPPES record last updated: June 1, 2018. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Tibebu Mekonnen Tsegga D.d.s. NPPES

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

DR. TIBEBU MEKONNEN TSEGGA D.D.S. (NPI 1528149358) is an individual oral and maxillofacial surgery provider in Jbsa Lackland, Texas, licensed in Texas (28366) and active in the NPI registry since October 2006. He has opted out of Medicare through July 30, 2026 and remains eligible to order and refer and maintains a secondary practice location in Travis Afb.

NPPES Registry Identity

NPI1528149358
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. TIBEBU MEKONNEN TSEGGACredential: D.D.S.
Location Address1100 WILFORD HALL LOOP BLDG 4554Jbsa Lackland, TX 78236
Mailing Address1100 Wilford Hall Loop Bldg 4554Jbsa Lackland, TX 78236-5638 · (615) 668-3322
Sole ProprietorNo
Enumeration DateOctober 18, 2006
Last NPPES UpdateJune 1, 2018
NPI 1528149358 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License Licensed in TX · 28366
Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

Also ListedDentist · General PracticeTaxonomy 1223G0001X · License 8585 (TN)
1100 WILFORD HALL LOOP BLDG 4554, Jbsa Lackland, TX 78236

Secondary Practice Location 1

Location 1151 Bodin CirTravis AFB, CA 94535-1801 · Phone (707) 423-7002

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Dr. Tibebu Mekonnen Tsegga D.d.s. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 30, 2020 through July 30, 2026.

Opt-Out Effective DateJuly 30, 2020
Opt-Out In Effect ThroughJuly 30, 2026Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78236 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

Ophthalmology (Glaucoma Specialist)
1100 WILFORD HALL LOOP BLDG 4554
JBSA LACKLAND, TX 78236
Family Medicine
1100 WILFORD HALL LOOP BLDG 4554
JBSA LACKLAND, TX 78236
Psychologist
1100 WILFORD HALL LOOP BLDG 4554
JBSA LACKLAND, TX 78236
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
1100 WILFORD HALL LOOP BLDG 4554
JBSA LACKLAND, TX 78236
Chiropractor
1100 WILFORD HALL LOOP BLDG 4554
JBSA LACKLAND, TX 78236
Physical Therapist (Orthopedic)
1100 WILFORD HALL LOOP BLDG 4554, ATTN: 59 MDW/SGHC
JBSA LACKLAND, TX 78236
Psychologist (Clinical)
1100 WILFORD HALL LOOP BLDG 4554
JBSA LACKLAND, TX 78236
Social Worker (Clinical)
1100 WILFORD HALL LOOP BLDG 4554
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 Tibebu Tsegga's NPI number?

The NPI number for Tibebu Tsegga is 1528149358. It was assigned to this individual provider in the NPPES registry on October 18, 2006.

Where is Tibebu Tsegga located?

Tibebu Tsegga practices at 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236. The listed phone number is (615) 668-3322.

What is Tibebu Tsegga's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Tibebu Tsegga enrolled in Medicare?

No. Tibebu Tsegga has opted out of Medicare through July 30, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Tibebu Tsegga accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 12 other insurers list Tibebu Tsegga as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Tibebu Tsegga was last updated on June 1, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.