Individual provider Active NPI

Clyde A Maxwell Jr., D.D.S.

  • Dentist
  • Wilmington, DE
National Provider Identifier
1568478477
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
G1-0001159 Issued in DE
Practice address
303 E Lea Blvd
Wilmington, DE 19802-2353
Phone
(302) 765-3373
Fax
(302) 765-3379
NPI assigned
Jul 31, 2006
Last updated
May 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X G1-0001159 DE Primary

Addresses

Primary practice location

303 E Lea Blvd
Wilmington, DE 19802-2353

Mailing address

303 E Lea Blvd
Wilmington, DE 19802-2353
Phone (302) 476-8896

Other identifiers 1

IdentifierTypeStateIssuer
1000015890MedicaidDE

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
G1-0001159DEMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Clyde a. Maxwell Jr, PA Dentist CurrentSince Jun 30, 2024 Accepting new patients
Word of Mouth Ministries Inc Current Accepting new patients

Locations

303 E Lea Blvd
Wilmington, DE 19802
Phone (302) 476-8896

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1568478477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 E LEA BLVD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198022353",
            "telephone_number": "302-476-8896",
            "fax_number": "302-842-2159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 E LEA BLVD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198022353",
            "telephone_number": "302-765-3373",
            "fax_number": "302-765-3379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "CLYDE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "DE",
            "license": "G1-0001159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000015890",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.