Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1235098005 Individual Practitioner Male Practitioner

Dr. Maxwell Theodore Dismuke , DDS

Dentist • Redway, CA

Professional Overview & Biography Verified Profile Summary

Dr. Maxwell Dismuke, DDS is a certified Dentist practicing in Redway, CA. With approximately 1 years of clinical experience since completing medical education in 2025, Dr. Dismuke delivers high-quality medical care to the local community at 101 WEST COAST RD.

Dr. Dismuke does not directly accept Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

101 West Coast Rd

Redway, CA 95560

Telephone 7079232783
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Other

Graduation Year

2025

Medicare Assignment

Not Specified

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Redway, CA

Rising Specialist (<5 Yrs)
Practitioner Clinical Experience
1 Yrs -13.5 yrs vs City Avg
City Avg: 14.5 Yrs
State Avg: 14.4 Yrs
Regional Practice Density
4 Specialists

Practicing in Redway, CA (15331 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Dismuke (1 Years) 1 Yrs
Redway Specialty Average (14.5 Years) 14.5 Yrs

Medical Specialties & State Licenses

CMS Verified: 2026-04-21
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License CA 112497

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Secondary Practice Locations

217 Briceland Thorn Rd

Redway, CA 95560

Phone: 7079232783

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

23 Associated Practitioners
Morgan Hines

Physician Assistant - Medical

NPI 1013482231
NPI 1124242888
Dr. Anne Njoku , DNP, FNP-C, BSN, RN

Nurse Practitioner - Family

NPI 1174356216

Doctor of Nursing Practice, Family Nurse Practitioner (Certified), Bachelor of Science in Nursing, Registered Nurse

Sarah Lippitt Houston , FNP

Nurse Practitioner - Family

NPI 1306141676

Family Nurse Practitioner

Anthony Pirouz , PA-C

Physician Assistant

NPI 1366833923

Physician Assistant (Certified)

Tiffany Nickens , PA-C

Physician Assistant - Medical

NPI 1386136778

Physician Assistant (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location April 21, 2026

Registered at 101 WEST COAST RD, REDWAY, CA 95560 (Tel: 7079232783)

📍
Updated Business Mailing Address April 21, 2026

Registered at PO BOX 769, REDWAY, CA 955600769 (Tel: 7079232783)

NPI Profile Active January 19, 2026

NPI status registered as active in NPPES database

📍
Updated Practice Location January 19, 2026

Registered at 4220 PINE AVE, LONG BEACH, CA 908071926 (Tel: 5622306292)

📍
Updated Business Mailing Address January 19, 2026

Registered at 4220 PINE AVE, LONG BEACH, CA 908071926 (Tel: 5622306292)

👤
Provider Name / Credentials Updated January 19, 2026

Recorded as MAXWELL DISMUKE, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 19, 2026

Dentist (License #112497 in CA)

🟢
Initial NPI Registration & Enumeration January 19, 2026

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1235098005
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 19, 2026
Last Update: April 21, 2026
Sole Proprietor: Yes

Mailing Address

Po Box 769

Redway, CA 955600769

Phone: 7079232783

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.