Healthcare Provider Details

I. General information

NPI: 1043605793
Provider Name (Legal Business Name): DAWN MAXEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2015
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 LAWRENCE EXPY DEPT 325
SANTA CLARA CA
95051-5173
US

IV. Provider business mailing address

700 LAWRENCE EXPY
SANTA CLARA CA
95051-5173
US

V. Phone/Fax

Practice location:
  • Phone: 408-851-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMDRE.ML.60564090
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number13289381-1205
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA156507
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: