Maxwell Theodore Dismuke, DDS in Redway, CA

Maxwell Theodore Dismuke, DDS is a medicare enrolled "Dentist" provider in Redway, California. He graduated from medical school in 2025 and has 1 years of diverse experience with area of expertise as Dentist. His current practice location is 217 Briceland Thorn Rd, Redway, California. You can reach out to his office (for appointments etc.) via phone at (707) 923-2783.

Maxwell Theodore Dismuke is licensed to practice in California (license number 112497) and he also participates in the medicare program. He may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1235098005.

Contact Information

	Maxwell Theodore Dismuke, DDS
	217 Briceland Thorn Rd, Redway, CA 95560
	(707) 923-2783
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Maxwell Theodore Dismuke
Gender	Male
Speciality	Dentist
Experience	1 Years
Location	217 Briceland Thorn Rd, Redway, California
Accepts Medicare Assignments	May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance.

Medical Education and Training:

Maxwell Theodore Dismuke graduated from medical school in 2025

NPI Data:

NPI Number: 1235098005
Provider Enumeration Date: 01/19/2026
Last Update Date: 09/03/2026

Medicare PECOS Information:

PECOS PAC ID: 7517435142
Enrollment ID: I20260501002118

Medical Identifiers

Medical identifiers for Maxwell Theodore Dismuke such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1235098005	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
122300000X	Dentist	112497 (California)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Maxwell Theodore Dismuke allows following entities to bill medicare on his behalf.

Entity Name	Redwoods Rural Health Center Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1235206087 PECOS PAC ID: 6709867583 Enrollment ID: O20230102000224

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Maxwell Theodore Dismuke is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Maxwell Theodore Dismuke, DDS Po Box 769, Redway, CA 95560-0769 Ph: (707) 923-2783	Maxwell Theodore Dismuke, DDS 217 Briceland Thorn Rd, Redway, CA 95560 Ph: (707) 923-2783

Reviews and Comments

Dentist in Redway, CA

Dr. Blake Jerome Olson, D.D.S. Dentist Medicare: Medicare Enrolled Practice Location: 101 Westcoast Rd., Redway, CA 95560 Phone: 707-923-4313 Fax: 707-923-2590
Roopkamal Singh Kahlon, DDS Dentist Medicare: Medicare Enrolled Practice Location: 101 West Coast Rd, Redway, CA 95560 Phone: 707-923-2783
Gelareh Rahbar, DDS Dentist Medicare: May Accept Medicare Assignments Practice Location: 101 West Coast Rd, Redway, CA 95560 Phone: 707-923-2783
Renettra Angele Morris, D.D.S Dentist Medicare: Medicare Enrolled Practice Location: 101 West Coast Rd. #a, Redway, CA 95560 Phone: 707-923-4313
Dr. Steve A Norton, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 76 Briceland Rd, Redway, CA 95560 Phone: 707-923-9060 Fax: 707-923-9660
Dr. Lorraine Prisbrey, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 101 West Coast Rd., Redway, CA 95560 Phone: 707-923-4313 Fax: 707-923-2590

Maxwell Theodore Dismuke, DDS - Medicare Dentist in Redway, CA