William E Zwack, D.D.S.
Individual provider Active NPI Oral and Maxillofacial Surgery (Dentist) · Fredench, MD
NPI 1841292992 · NPPES record last updated Jan 9, 2009
Key facts
- NPI
- 1841292992
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist) 1223S0112X
- License
- 13178 (MD)
- Practice address
- 68 Thomas Johnson Drive
Suite a
Fredench, MD 21702 - Phone
- (301) 694-2300
- Fax
- (301) 694-7372
- NPI assigned
- Jun 1, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
- Opted out of Medicare
- Previously, effective Sep 1, 2014 through Sep 1, 2026
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13178 | MD | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients | |
| Associated Oral & Maxillofacial Surgeons, PC | Oral and Maxillofacial Surgery | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 13178 | MD | Yes |
Addresses
Primary practice location
68 Thomas Johnson Drive
Suite a
Fredench, MD 21702
Mailing address
68 Thomas Johnson Drive
Suite a
Fredench, MD 21702
Phone (301) 694-2300
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.