MAXWELL THEODORE DISMUKE DDS
NPI 1235098005
Dentist in Redway, CA
About Maxwell Theodore Dismuke Dds NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MAXWELL THEODORE DISMUKE DDS (NPI 1235098005) is an individual dentist in Redway, California, licensed in California (112497) and active in the NPI registry since January 2026. He is enrolled in Medicare PECOS, maintains a secondary practice location in Redway, and is a graduate of Other (2025).
NPPES Registry Identity
Specialties & Licenses
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
Secondary Practice Location 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Maxwell Theodore Dismuke Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 95560 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 8
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
REDWAY, CA 95560
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 Maxwell Dismuke's NPI number?
The NPI number for Maxwell Dismuke is 1235098005. It was assigned to this individual provider in the NPPES registry on January 19, 2026.
Where is Maxwell Dismuke located?
Maxwell Dismuke practices at 101 West Coast Rd, Redway, CA 95560. The listed phone number is (707) 923-2783.
What is Maxwell Dismuke's specialty?
The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.
Is Maxwell Dismuke enrolled in Medicare?
Yes. Maxwell Dismuke is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Maxwell Dismuke was last updated on April 21, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.
