MEDICARE: WILLIAM M. DORFMAN D.D.S.

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1386572030
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLIAM M. DORFMAN D.D.S.

Provider Business Mailing Address
First Line	:	2080 CENTURY PARK E STE 1601
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90067-2019
Country	:	US
Telephone Number	:	310-277-5678
Fax Number	:

Provider Business Practice Location Address
First Line	:	2080 CENTURY PARK E STE 1601
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90067-2019
Country	:	US
Telephone Number	:	310-277-5678
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF PAYOR CONTRACTING
Name	:	CASEY CASTLE
Credential	:
Telephone Number	:	912-732-1504

Provider Enumeration Date	:	05/12/2026
Last Update Date	:	05/12/2026

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