MEDICARE: MAXWELL JAMES RUMBARGER 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	390200000X	Student in an Organized Health Care Education/Training Program		OH

General Provider Information

NPI Number	:	1932046877
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAXWELL JAMES RUMBARGER DDS

Provider Business Mailing Address
First Line	:	2925 N TRILLIUM LN
Second Line	:
City	:	PORT CLINTON
State	:	OH
Zip	:	43452-4021
Country	:	US
Telephone Number	:	419-635-5302
Fax Number	:

Provider Business Practice Location Address
First Line	:	540 BUCHANAN ST
Second Line	:
City	:	SANDUSKY
State	:	OH
Zip	:	44870-4749
Country	:	US
Telephone Number	:	419-502-0257
Fax Number	:

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

Provider Enumeration Date	:	04/29/2026
Last Update Date	:	04/29/2026

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