Djavan Wharton-lake, - Medicare Dentist in Hyattsville, MD

Djavan Wharton-lake, is a medicare enrolled "Dentist - Endodontics" provider in Hyattsville, Maryland. His current practice location is 2045 University Blvd E Ste 204, Hyattsville, Maryland. You can reach out to his office (for appointments etc.) via phone at (626) 254-0207.

Djavan Wharton-lake is licensed to practice in California (license number 65036) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1174938906.

Contact Information

Djavan Wharton-lake,
2045 University Blvd E Ste 204,
Hyattsville, MD 20783-4137
(626) 254-0207
(626) 254-8679



Healthcare Provider's Profile

Full NameDjavan Wharton-lake
GenderMale
SpecialityDentist - Endodontics
Location2045 University Blvd E Ste 204, Hyattsville, Maryland
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1174938906
  • Provider Enumeration Date: 07/01/2014
  • Last Update Date: 01/18/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 7719217660
  • Enrollment ID: I20190919002325

Medical Identifiers

Medical identifiers for Djavan Wharton-lake such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1174938906NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1223E0200XDentist - Endodontics 0401417776 (Virginia)Secondary
1223E0200XDentist - Endodontics 17787 (Maryland)Secondary
1223E0200XDentist - Endodontics 65036 (California)Primary

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. Djavan Wharton-lake 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 AddressPractice Location Address
Djavan Wharton-lake,
628 Webster St Nw,
Washington, DC 20011-4656

Ph: (301) 996-4055
Djavan Wharton-lake,
2045 University Blvd E Ste 204,
Hyattsville, MD 20783-4137

Ph: (626) 254-0207

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Dentist in Hyattsville, MD

Dr. Lourdes I. Sanchez, DDS
Dentist
Medicare: Medicare Enrolled
Practice Location: 7105 Riggs Rd, Hyattsville, MD 20783
Phone: 301-422-8936    Fax: 301-422-0400
Dr. Lorraine Rodriguez, DDS
Dentist
Medicare: Medicare Enrolled
Practice Location: 2970 Belcrest Center Drive Ste 105, Ibrush Family Dental Care, Hyattsville, MD 20782
Phone: 786-205-1900    
Dr. Marie Surasky, DDS
Dentist
Medicare: Not Enrolled in Medicare
Practice Location: 5310 Kenilworth Ave, Hyattsville, MD 20781
Phone: 301-277-1214    
Dr. Allan Carl Johnson, DMD
Dentist
Medicare: Not Enrolled in Medicare
Practice Location: 4605 69th Avenue, Hyattsville, MD 20784
Phone: 301-772-2224    Fax: 301-772-2289
Dr. Albert M Quashie Jr., DDS
Dentist
Medicare: Not Enrolled in Medicare
Practice Location: 3331 Toledo Ter, Suite 308, Hyattsville, MD 20782
Phone: 301-559-1500    Fax: 301-559-7154
Dr. Rama Devi Raparthi, D.D.S
Dentist
Medicare: Medicare Enrolled
Practice Location: 3114 Queens Chapel Rd, Hyattsville, MD 20782
Phone: 301-338-8888    
Mahmoud Foad Nasr, D.D.S.
Dentist
Medicare: Not Enrolled in Medicare
Practice Location: 3512 Longfellow St, Hyattsville, MD 20782
Phone: 301-927-7500    Fax: 301-927-7629

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