Michael David Maxfield, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DE60171326 Issued in WA

Practice address

4476 W Van Giesen St
West Richland, WA 99353-5411

Phone

(509) 967-3421

NPI assigned

Jul 28, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Yes, effective Mar 10, 2015 through Mar 10, 2027

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Madsen, Maxfield, Karlson, Clements, McManamon, PLLC

  dba Prime Dental Kennewick

  • General Practice Dentistry
  • Kennewick, WA
  • NPI 1811845308
  NPD (past)
• Penttila Schroeder Maxfield,DDS, PS

  dba West Richland Family Dental Center

  • General Practice Dentistry
  • West Richland, WA
  • NPI 1619915394
  NPD (past)

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

{
    "created_epoch": "1280275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280275200000",
    "number": "1760796171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11013 W COURT ST",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993016595",
            "telephone_number": "509-380-0504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4476 W VAN GIESEN ST",
            "city": "WEST RICHLAND",
            "state": "WA",
            "postal_code": "993535411",
            "telephone_number": "509-967-3421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXFIELD",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-28",
        "last_updated": "2010-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60171326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trevor Lott, D.O.
• Jason Madsen, DDS
• Walter Hugh Maloney, MD
• Paul M Matiaco, DO
• Tania Milad Matta, MD
• Ronald Orin Maxfield, DDS
• Marie L McElderry, RDH, BS
• Christa Medlock, LMP
• Ricardo Melendrez Jr., PA-C
• Wendy Mineke

• Dentist in West Richland, WA
• Providers in West Richland, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2010; 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.