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

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
Mailing address1250 9th Ave Apt 5, San Francisco, CA 94122-2333

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