Bontu Deressa

ActiveIndividual ProviderSpecialty not listed
NPI issued: June 1, 2026

Quick Facts

NPI Number
1720910086
TypeIndividual
StatusActive
SpecialtySpecialty not listed
Taxonomy390200000X — Specialty not listed
Phone
(763) 318-8981
StateMN

NPI Validation Status: Verified

Valid 10-digit NPI number (1720910086)
Active status confirmed
Verified by CMS NPPES Registry
HIPAA compliant identifier
Enumeration date on file (June 1, 2026)
Data source: CMS NPPES

Provider Overview

BONTU DERESSA is a Healthcare provider based in Blaine, MN who has been registered with CMS since 2026. This NPI is currently Active under CMS NPPES registry.

Provider Details

NPI Number1720910086
Provider TypeIndividual Provider
GenderNot specified
StatusActive
Enumeration DateJune 1, 2026

Practice Location

CityBlaine
StateMN
ZIP Code55449-7702
Phone(763) 318-8981

Specialties & Licenses

★ Primary
SpecialtySpecialty not listed
Taxonomy Code390200000X
License StateMN

Mailing Address

CityBlaine
StateMN
ZIP Code55449-7702
Phone(763) 318-8981
Same as practice location

How to Use This NPI

📋

For Insurance Billing

Use NPI 1720910086 in Box 33 of the CMS-1500 claim form. This number is required by all major insurance carriers to identify the billing provider and process electronic medical claims.

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For Credentialing

Reference NPI 1720910086for provider credential verification. Hospital systems, state licensing boards, and CAQH directories query this number to verify the provider's active clinical status.

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For Patients

Share NPI 1720910086 with your insurance company. If you need to verify out-of-network benefits or file a reimbursement claim, your insurance provider will require this number to process it.

About Specialty not listed

Specialists in Specialty not listed provide expert clinical care within their specific domain, focusing on the diagnosis, treatment, and management of conditions relevant to their field of practice.

📊
361,604
Specialty not listed Providers in the US

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Olivia Crane

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Olabisi Abokede-rahaman, TRAINING CERT MD

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People Also Ask

What is Bontu Deressa's NPI number?
Bontu Deressa's NPI number is 1720910086, a unique 10-digit identifier issued by the Centers for Medicare & Medicaid Services (CMS).
Is Bontu Deressa's NPI currently active?
Yes, Bontu Deressa's NPI status is Active as of the latest CMS NPPES database updates.
What does Bontu Deressa specialize in?
Bontu Deressa specializes in Specialty not listed. The healthcare taxonomy code associated with this specialty is 390200000X.
Where does Bontu Deressa practice?
Bontu Deressa practices in Blaine, MN 55449-7702.
When was Bontu Deressa's NPI issued?
Bontu Deressa's NPI was issued on June 1, 2026.
What is Bontu Deressa's provider type?
Bontu Deressa is registered as an Individual Provider under CMS NPI Type 1.