MEDICARE: PETER A WINKELMAN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	6519	MD
2	1223G0001X	General Practice Dentistry	6519	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295993004
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER A WINKELMAN DDS

Provider Business Mailing Address
First Line	:	12114 GEORGIA AVE
Second Line	:
City	:	WHEATON
State	:	MD
Zip	:	20902-5522
Country	:	US
Telephone Number	:	301-942-5500
Fax Number	:	301-942-5520

Provider Business Practice Location Address
First Line	:	12114 GEORGIA AVE
Second Line	:
City	:	WHEATON
State	:	MD
Zip	:	20902-5522
Country	:	US
Telephone Number	:	301-942-5500
Fax Number	:	301-942-5520

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2008
Last Update Date	:	05/29/2008

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