Individual provider Active NPI

Abigail Susan Widman, DDS

  • Dentist
  • Prince Frederick, MD
National Provider Identifier
1538807987
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
18738 Issued in MD
Practice address
284 Merrimac CT
Prince Frederick, MD 20678-4133
Phone
(410) 535-2011
NPI assigned
May 25, 2022
Last updated
Jun 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 18738 MD Primary
General Practice Dentistry 1223G0001X 0401419192 VA

Addresses

Primary practice location

284 Merrimac CT
Prince Frederick, MD 20678-4133

Mailing address

552 N Saint Asaph St
Alexandria, VA 22314-2320
Phone (614) 905-9608

Other practice location 1

6707 Old Dominion Dr Ste 240
Mc Lean, VA 22101-4503
Phone (703) 745-5226

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0401419192VAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1653436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780876800000",
    "number": "1538807987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "552 N SAINT ASAPH ST",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223142320",
            "telephone_number": "614-905-9608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "284 MERRIMAC CT",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206784133",
            "telephone_number": "410-535-2011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6707 Old Dominion Dr Ste 240",
            "address_purpose": "LOCATION",
            "city": "Mc Lean",
            "state": "VA",
            "postal_code": "221014503",
            "country_code": "US",
            "telephone_number": "703-745-5226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIDMAN",
        "first_name": "ABIGAIL",
        "middle_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-25",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "18738",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401419192",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prince Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2026; 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.