Individual provider Active NPI

Marvin Thomas

  • Oral and Maxillofacial Surgery (Dentist)
  • Berwyn Heights, MD
National Provider Identifier
1619530086
Registry record updated Sep 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
18433 Issued in MD
Practice address
6201 Greenbelt Rd Ste M1
Berwyn Heights, MD 20740-2358
Phone
(301) 345-7007
NPI assigned
Apr 20, 2019
Last updated
Sep 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 18433 MD Primary

Addresses

Primary practice location

6201 Greenbelt Rd Ste M1
Berwyn Heights, MD 20740-2358

Mailing address

6201 Greenbelt Rd Ste M1
Berwyn Heights, MD 20740-2358
Phone (301) 345-7007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190606001482 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4385977305

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18433MDMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Maryland Oral Surgery Associates, LLC Oral and Maxillofacial Surgery PastSince Sep 21, 2025 Accepting new patients

Organizations & group practices 1

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": "1555718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758153600000",
    "number": "1619530086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENBELT RD STE M1",
            "city": "BERWYN HEIGHTS",
            "state": "MD",
            "postal_code": "207402358",
            "telephone_number": "301-345-7007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 GREENBELT RD STE M1",
            "city": "BERWYN HEIGHTS",
            "state": "MD",
            "postal_code": "207402358",
            "telephone_number": "301-345-7007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "MARVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-20",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MD",
            "license": "18433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn Heights, MD

Sources for this page

Verify at the official NPI Registry.