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PETER M TAN DDS MSHS
NPI 1639141609
Oral & Maxillofacial Surgery in Frederick, MD

Active since February 03, 2006Opted out of Medicare · through Sep 1, 2026
68 THOMAS JOHNSON DR, SUITE A, FREDERICK, MD 21702(301) 694-2300(301) 694-7372 Get Directions Write a Review

NPPES record last updated: June 21, 2010. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Peter M Tan Dds Mshs NPPES

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

PETER M TAN DDS MSHS (NPI 1639141609) is an individual oral & maxillofacial surgery provider in Frederick, Maryland, licensed in Maryland (08276) and active in the NPI registry since February 2006. He has opted out of Medicare through September 1, 2026 and remains eligible to order and refer.

NPPES Registry Identity

NPI1639141609
Entity TypeIndividualMale
Primary Taxonomy204E00000X
Provider Legal NamePETER M TANCredential: DDS MSHS
Location Address68 THOMAS JOHNSON DR, SUITE AFrederick, MD 21702
Mailing Address68 Thomas Johnson Dr, Suite AFrederick, MD 21702 · (301) 694-2300 · Fax (301) 694-7372
Phone(301) 694-2300
Fax(301) 694-7372
Sole ProprietorNo
Enumeration DateFebruary 3, 2006
Last NPPES UpdateJune 21, 2010
✔ NPI 1639141609 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code204E00000X
License✔ Licensed in MD · 08276
Definition
Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.
68 THOMAS JOHNSON DR, Frederick, MD 21702
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Other Identifiers 7

OtherDE94Bcbs Dental
Other37385Dental Benefit Providers
Other952901Ucci
Medicare ID-Type Unspecified733L585D
Medicare UPINU43822
Other60443Tricare Prime
Other410662Mamsi

Accepted Insurance

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

Peter M Tan Dds Mshs 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 September 1, 2014 through September 1, 2026.

Opt-Out Effective DateSeptember 1, 2014
Opt-Out In Effect ThroughSeptember 1, 2026Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 6

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

MARK MAZIN
Dentist (General Practice)
68 THOMAS JOHNSON DR
FREDERICK, MD 21702
Frederick County (301) 620-9090
MRS. THERESA MARIE GILLIS PA-C
Physician Assistant
68 THOMAS JOHNSON DR, SUITE C
FREDERICK, MD 21702
Frederick County (301) 694-5292
JOHN PINETTI
Dentist (General Practice)
68 THOMAS JOHNSON DR
FREDERICK, MD 21702
Frederick County (301) 620-9090
DIANE S. FORD M.D.
Dermatology (Procedural Dermatology)
68 THOMAS JOHNSON DR, SUITE C
FREDERICK, MD 21702
Frederick County (301) 694-5292
MID-MARYLAND ORAL AND MAXILLOFACIAL SURGERY PA
Clinic/Center (Oral and Maxillofacial Surgery)
68 THOMAS JOHNSON DR, SUITE A
FREDERICK, MD 21702
Frederick County (301) 694-2300
GLENN PRITCHARD
Dentist (General Practice)
68 THOMAS JOHNSON DR
FREDERICK, MD 21702
Frederick County (301) 620-9090

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 Peter Tan's NPI number?

The NPI number for Peter Tan is 1639141609. It was assigned to this individual provider in the NPPES registry on February 3, 2006.

Where is Peter Tan located?

Peter Tan practices at 68 Thomas Johnson Dr Suite A, Frederick, MD 21702. The listed phone number is (301) 694-2300.

What is Peter Tan's specialty?

The primary specialty registered for this NPI is Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

Is Peter Tan enrolled in Medicare?

No. Peter Tan has opted out of Medicare through September 1, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Peter Tan accept?

Health plans from BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and HRI Dental & Vision and 2 other insurers list Peter Tan 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 Peter Tan was last updated on June 21, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.