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DR. DOUGLAS KEEN TAVENNER JR. D.D.S.
NPI 1174678262
Dentist - General Practice in Frederick, MD

Active since January 25, 2007PECOS Enrolled
20 MOUNTAIN GATE DRIVE, FREDERICK, MD 21703(301) 662-0100 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Douglas Keen Tavenner Jr. D.d.s. NPPES

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

DR. DOUGLAS KEEN TAVENNER JR. D.D.S. (NPI 1174678262) is an individual general practice provider in Frederick, Maryland, licensed in Maryland (5112) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174678262
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. DOUGLAS KEEN TAVENNER JR.Credential: D.D.S.
Location Address20 MOUNTAIN GATE DRIVEFrederick, MD 21703-6098
Mailing Address20 Mountain Gate DriveFrederick, MD 21703-6098 · (301) 662-0100
Phone(301) 662-0100
Sole ProprietorYes
Enumeration DateJanuary 25, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1174678262 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in MD · 5112
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.
20 MOUNTAIN GATE DRIVE, Frederick, MD 21703
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Douglas Keen Tavenner Jr. D.d.s. 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 21703 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
$89.75 typical visit price
range $57.99 – $175.57
Typical copayment $22.43 (range $14.49 – $43.89)
Most-billed visit code 99203
Established Patient
$72.23 typical visit price
range $18.66 – $143.02
Typical copayment $18.05 (range $4.66 – $35.75)
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 Douglas Tavenner's NPI number?

The NPI number for Douglas Tavenner is 1174678262. It was assigned to this individual provider in the NPPES registry on January 25, 2007.

Where is Douglas Tavenner located?

Douglas Tavenner practices at 20 Mountain Gate Drive, Frederick, MD 21703. The listed phone number is (301) 662-0100.

What is Douglas Tavenner's specialty?

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

Is Douglas Tavenner enrolled in Medicare?

Yes. Douglas Tavenner is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Douglas Tavenner was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.