William Maxwell Wahle, D.D.S., MS

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

15922 Issued in MD

Practice address

110 West Rd Ste 200
Towson, MD 21204-2341

Phone

(410) 296-0136

NPI assigned

Apr 15, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Previously, effective Aug 10, 2016 through Aug 10, 2026

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Greater Baltimore Prosthodontics PA

  • Prosthodontics
  • Towson, MD
  • NPI 1841287034
  NPD (past)

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

{
    "created_epoch": "1460678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583884800000",
    "number": "1083068027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 WEST RD STE 200",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042341",
            "telephone_number": "410-296-0136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 WEST RD STE 200",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042341",
            "telephone_number": "410-296-0136"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "650 W Baltimore St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212011510",
            "country_code": "US",
            "telephone_number": "410-706-7952",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAHLE",
        "first_name": "WILLIAM",
        "middle_name": "MAXWELL",
        "credential": "D.D.S., MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-15",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "DDS-09045",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "MD",
            "license": "15922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND DENTAL BOARD",
            "identifier": "15922",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abigail Votta
• Tina Wachter
• Susan C Wade, O.T.
• Leslie Wagner, LCSW-C
• Nicole A. M. Wagonheim, M.S. CCC-SLP
• Diana L Walcutt, PH.D.
• Walgreen Co (Walgreens #13606)
• Walgreen Co (Walgreens #16197)
• Walgreen Co. (Walgreens #13606)
• Emily Walker, LCPC

• Prosthodontics in Towson, MD
• Providers in Towson, MD by specialty
• Prosthodontics in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.