Daryl Bayard Witt, DDS

Individual provider Active NPI General Practice Dentistry · Laytonsville, MD

NPI 1710078852 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1710078852
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
05933 (MD)
Practice address
6835 Olney Laytonsville Road
Suite 200
Laytonsville, MD 20882
Phone
(301) 977-8855
Fax
(301) 977-8856
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160509000972 MD Order and Referring Only - Dentist
Practitioner - Dentist
3375842628

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
05933MDMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 05933 MD Yes

Addresses

Primary practice location

6835 Olney Laytonsville Road
Suite 200
Laytonsville, MD 20882

Mailing address

PO Box 5066
Laytonsville, MD 20882
Phone (301) 977-8855

Other providers in Laytonsville, MD

All providers in Laytonsville, MD · General Practice Dentistry in Maryland

Sources for this page

Verify at the official NPI Registry.