Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Ethan DO, DDS

Individual provider Dentist · NPI 1467921288

Dr. Ethan DO, DDS is a Dentist in Berkeley, California. Licensed in California. Registered with an NPI since 2018.

Licensed in
CA
In the registry since
2018
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

3017 Telegraph Ave Ste 310
Berkeley, CA 94705-2049
Phone: (510) 841-7424
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 103035 (CA)

Record details

NPI number1467921288
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedNovember 21, 2018
Last updated in NPPESNovember 21, 2018

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