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DR. BRADLEY DAVID WILTBANK DMD
NPI 1245438324
Dentist - Oral and Maxillofacial Surgery in Mc Lean, VA

Active since July 10, 2007Opted out of Medicare · through Mar 6, 2027
1313 DOLLEY MADISON BLVD, SUITE #209, MC LEAN, VA 22101(703) 356-7890 Get Directions Write a Review

NPPES record last updated: December 30, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Bradley David Wiltbank Dmd NPPES

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

DR. BRADLEY DAVID WILTBANK DMD (NPI 1245438324) is an individual oral and maxillofacial surgery provider in Mc Lean, Virginia, licensed in Virginia (0401414248) and active in the NPI registry since July 2007. He has opted out of Medicare through March 6, 2027.

NPPES Registry Identity

NPI1245438324
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. BRADLEY DAVID WILTBANKCredential: DMD
Location Address1313 DOLLEY MADISON BLVD, SUITE #209Mc Lean, VA 22101-3953
Mailing Address6836 Chelsea RdMc Lean, VA 22101-2803 · (425) 280-5252
Phone(703) 356-7890
Sole ProprietorNo
Enumeration DateJuly 10, 2007
Last NPPES UpdateDecember 30, 2021
NPPES CertifiedDecember 30, 2021
✔ NPI 1245438324 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in VA · 0401414248
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Also ListedDentistTaxonomy 122300000X · License 0401414248 (VA)
Also ListedDentist · General PracticeTaxonomy 1223G0001X · License D8944 (OR), DE00011246 (WA)
1313 DOLLEY MADISON BLVD, Mc Lean, VA 22101
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Bradley David Wiltbank Dmd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from March 6, 2025 through March 6, 2027.

Opt-Out Effective DateMarch 6, 2025
Opt-Out In Effect ThroughMarch 6, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 11

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

DR. BRUCE EDWARD LESSIN M.D.
Internal Medicine
1313 DOLLEY MADISON BLVD, SUITE 207
MCLEAN, VA 22101
Fairfax County (703) 821-1677
DR. WENDY C GARSON, P.C.
Optometrist
1313 DOLLEY MADISON BLVD, SUITE 305
MCLEAN, VA 22101
Fairfax County (703) 442-0522
DR. VAN GIAO LE D.D.S.
Dentist (General Practice)
1313 DOLLEY MADISON BLVD, SUITE 209
MC LEAN, VA 22101
Fairfax County (703) 356-7890
BRUCE E LESSIN M D P C
Internal Medicine
1313 DOLLEY MADISON BLVD, SUITE 207
MC LEAN, VA 22101
Fairfax County (703) 821-1677
J-N VISION PC
Optometrist
1313 DOLLEY MADISON BLVD, SUITE 305
MC LEAN, VA 22101
Fairfax County (703) 988-7744
ADISA MUJKIC DPM
Podiatrist (Foot & Ankle Surgery)
1313 DOLLEY MADISON BLVD, SUITE 403
MC LEAN, VA 22101
Fairfax County (703) 556-8673
DR. EDWARD CHUN D.D.S.
Dentist (Endodontics)
1313 DOLLEY MADISON BLVD, SUITE 307
MC LEAN, VA 22101
Fairfax County (703) 847-0989
DR. JOHN TIMOTHY DEWINKLER D.D.S.
Dentist (General Practice)
1313 DOLLEY MADISON BLVD, SUITE 209
MC LEAN, VA 22101
Fairfax County (703) 356-7890

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 Bradley Wiltbank's NPI number?

The NPI number for Bradley Wiltbank is 1245438324. It was assigned to this individual provider in the NPPES registry on July 10, 2007.

Where is Bradley Wiltbank located?

Bradley Wiltbank practices at 1313 Dolley Madison Blvd Suite #209, Mc Lean, VA 22101. The listed phone number is (703) 356-7890.

What is Bradley Wiltbank's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Bradley Wiltbank enrolled in Medicare?

No. Bradley Wiltbank has opted out of Medicare through March 6, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Bradley Wiltbank accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas list Bradley Wiltbank 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 Bradley Wiltbank was last updated on December 30, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.