David Matthew Wallitt, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8996 Issued in SC

Practice address

652 Hamilton Road
Fort Sill, OK 73503

Phone

(580) 442-3905

NPI assigned

Aug 15, 2017

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1502755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532044800000",
    "number": "1003332784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "652 HAMILTON ROAD",
            "city": "FORT SILL",
            "state": "OK",
            "postal_code": "73503",
            "telephone_number": "580-442-3905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "652 HAMILTON ROAD",
            "city": "FORT SILL",
            "state": "OK",
            "postal_code": "73503",
            "telephone_number": "580-442-3905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLITT",
        "first_name": "DAVID",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-15",
        "last_updated": "2018-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "8996",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "8996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Albert Minh Vu, PA-C
• Kenneth Ray Waggoner, LPC, LADC
• Richard Carl Wahl, MD
• Meyon Sheree Walker
• Nikki Walker, CPHT
• Codi Rebekah Warren Heinzeroth, RD LD
• Dominique A. Watt, LCSW
• Debra Marie Webb, D.O.
• Jeanne Mofield Webb
• Linda Ann Wetmore, RN

• General Practice Dentistry in Fort Sill, OK
• Providers in Fort Sill, OK by specialty
• General Practice Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.