DR. CLYDE A. MAXWELL JR PA NPI 1053464560

NPI Information

  • NPI: 1053464560
  • Provider Name: DR. CLYDE A. MAXWELL JR, PA
  • Classification: Clinic/Center - 261QD0000X
  • Specialization: Dental
  • Entity Type: Organization
  • :
  • Address: 303 E LEA BLVD
    WILMINGTON, DE
    ZIP 19802
  • Phone: (302) 765-3373

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NPI Details

DR. CLYDE A. MAXWELL JR, PA is a dental clinic center in Wilmington, DE. DR. CLYDE A. MAXWELL JR, PA NPI is 1053464560. The provider is registered as an organization entity type and is a multi-specialty group.
The provider .

The provider's business location address is:

303 E LEA BLVD
WILMINGTON, DE
ZIP 19802-353
Phone: (302) 765-3373
Fax: (302) 765-3379

The provider's authorized official is Clyde A Maxwell .
The authorized official title is Dentist and has the following contact phone number (302) 476-8896.

The enumeration date for this NPI number is 1/19/2007 and was last updated on 12/8/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineG1-0001159DELAWARENo
2261QD0000XClinic/CenterDentalYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11000040828MEDICAIDDELAWARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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