DJAVAN WHARTON-LAKE
NPI 1174938906
Dentist - Endodontics in Hyattsville, MD

Q: What is Djavan Wharton-lake's NPI number?

The NPI number for Djavan Wharton-lake is 1174938906. It was assigned to this individual provider in the NPPES registry on July 1, 2014.

Q: What is Djavan Wharton-lake's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Endodontics, with taxonomy code 1223E0200X.

Active since July 01, 2014PECOS Enrolled

2045 UNIVERSITY BLVD E STE 204, HYATTSVILLE, MD 20783(626) 254-0207(626) 254-8679 Get Directions Write a Review

NPPES record last updated: November 19, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 19, 2024, Jan 18, 2022, Jun 25, 2018 (3 updates tracked since 2018).

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About Djavan Wharton-lake NPPES

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

DJAVAN WHARTON-LAKE (NPI 1174938906) is an individual endodontics provider in Hyattsville, Maryland, licensed in Virginia (0401417776) and active in the NPI registry since July 2014. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174938906

Entity TypeIndividualMale

Primary Taxonomy1223E0200X

Provider Legal NameDJAVAN WHARTON-LAKE

Location Address2045 UNIVERSITY BLVD E STE 204Hyattsville, MD 20783-4137

Mailing Address628 Webster St NwWashington, DC 20011-4656 · (301) 996-4055

Phone(626) 254-0207

Fax(626) 254-8679

Sole ProprietorYes

Enumeration DateJuly 1, 2014

Last NPPES UpdateNovember 19, 20243 updates tracked since enumeration

NPPES CertifiedNovember 19, 2024

✔ NPI 1174938906 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · EndodonticsDental Providers

Taxonomy Code1223E0200X

Licenses✔ Licensed in VA · 0401417776✔ Licensed in CA · 65036✔ Licensed in SC · DGD.10963DS✔ Licensed in MD · 17787

Definition

The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.

2045 UNIVERSITY BLVD E STE 204, Hyattsville, MD 20783

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, Anthem Blue Cross and Blue Shield 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)

Djavan Wharton-lake 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 20783 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

$100.31 typical visit price

range $65.18 – $194.86

Typical copayment $25.07 (range $16.29 – $48.71)

Most-billed visit code 99203

Established Patient

$80.66 typical visit price

range $21.40 – $158.88

Typical copayment $20.16 (range $5.35 – $39.72)

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.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GREATER MARYLAND ENDODONTICS, LLC

Dentist (Endodontics)

2045 UNIVERSITY BLVD E STE 204
HYATTSVILLE, MD 20783

Prince George's County (240) 842-9980

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 Djavan Wharton-lake's NPI number?

The NPI number for Djavan Wharton-lake is 1174938906. It was assigned to this individual provider in the NPPES registry on July 1, 2014.

Where is Djavan Wharton-lake located?

Djavan Wharton-lake practices at 2045 University Blvd E Ste 204, Hyattsville, MD 20783. The listed phone number is (626) 254-0207.

What is Djavan Wharton-lake's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Endodontics, with taxonomy code 1223E0200X.

Is Djavan Wharton-lake enrolled in Medicare?

Yes. Djavan Wharton-lake is registered in the Medicare PECOS enrollment system.

What insurance does Djavan Wharton-lake accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, Anthem Blue Cross and Blue Shield, BEST Life and Blue Cross and Blue Shield of Alabama and 13 other insurers list Djavan Wharton-lake 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 Djavan Wharton-lake was last updated on November 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months 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.