Maxwell Jacob Watzman, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901602359 Issued in MI

Practice address

707 E 12 Mile Rd
Madison Heights, MI 48071-2533

Phone

(248) 548-6110

Fax

(248) 548-6110

NPI assigned

Sep 3, 2024

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Edward Street Dental

  • General Practice Dentistry
  • Madison Heights, MI
  • NPI 1700864527
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1725321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1063247989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 E 12 MILE RD",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480712533",
            "telephone_number": "248-548-6110",
            "fax_number": "248-548-2718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 E 12 MILE RD",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480712533",
            "telephone_number": "248-548-6110",
            "fax_number": "248-548-6110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATZMAN",
        "first_name": "MAXWELL",
        "middle_name": "JACOB",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-03",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901602359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erik Warren, DDS
• Brandii-Mikayla Washington
• Lauren Marie Waters, LMSW
• Marowa Watfe, FNP
• Jeffrey Elliot Watzman, DDS
• Leigh Ann Wayna, LMSW
• Wce, LLC (Coop Optical)
• Lilith Aida Webb
• Curtis Wee, OD
• Marc F Weisman, DO

• General Practice Dentistry in Madison Heights, MI
• Providers in Madison Heights, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.