TADELE DEMISSE DMD
NPI 1942866280
Dentist - General Practice in Philadelphia, PA

Q: What is Tadele Demisse's NPI number?

The NPI number for Tadele Demisse is 1942866280. It was assigned to this individual provider in the NPPES registry on May 13, 2019.

Q: What is Tadele Demisse'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 Tadele Demisse was last updated on December 28, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 13, 2019PECOS Enrolled

6120B WOODLAND AVE, PHILADELPHIA, PA 19142(267) 597-3600 Get Directions Write a Review

NPPES record last updated: December 28, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 21, 2021, May 17, 2021, May 13, 2019 (3 updates tracked since 2019).

On this page

About Tadele Demisse Dmd NPPES

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

TADELE DEMISSE DMD (NPI 1942866280) is an individual general practice provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (DS043969) and active in the NPI registry since May 2019. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1942866280

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameTADELE DEMISSECredential: DMD

Location Address6120B WOODLAND AVEPhiladelphia, PA 19142-3224

Mailing Address4700 Wissahickon AvePhiladelphia, PA 19144-4248 · (267) 597-3600

Phone(267) 597-3600

Sole ProprietorNo

Enumeration DateMay 13, 2019

Last NPPES UpdateDecember 28, 20233 updates tracked since enumeration

NPPES CertifiedDecember 28, 2023

✔ NPI 1942866280 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

Licenses✔ Licensed in PA · DS043969✔ Licensed in NY · 061697

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.

6120B WOODLAND AVE, Philadelphia, PA 19142

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Other Identifiers 4

Medicaid02995513NY

Other53099ANY · Pin

Other331833NY · Oscar

Medicaid10000017080506PA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tadele Demisse Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19142 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

$92.69 typical visit price

range $59.88 – $180.99

Typical copayment $23.17 (range $14.97 – $45.24)

Most-billed visit code 99203

Established Patient

$74.47 typical visit price

range $19.30 – $147.29

Typical copayment $18.61 (range $4.82 – $36.82)

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.

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 Tadele Demisse's NPI number?

The NPI number for Tadele Demisse is 1942866280. It was assigned to this individual provider in the NPPES registry on May 13, 2019.

Where is Tadele Demisse located?

Tadele Demisse practices at 6120B Woodland Ave, Philadelphia, PA 19142. The listed phone number is (267) 597-3600.

What is Tadele Demisse's specialty?

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

Is Tadele Demisse enrolled in Medicare?

Yes. Tadele Demisse is registered in the Medicare PECOS enrollment system.

What insurance does Tadele Demisse accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Buckeye Health Plan, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 3 other insurers list Tadele Demisse 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 Tadele Demisse was last updated on December 28, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.