Active NPI
Brian Richard Witt, DMD PA
- Dentist
- Temple Terrace, FL
National Provider Identifier
1023101805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN14117
- Practice address
- 13214 Telecom Dr
Temple Terrace, FL 33637-0932 - Phone
- (813) 988-7489
- Fax
- (813) 977-7004
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN14117 | FL | Primary |
Addresses
Primary practice location
13214 Telecom Dr
Temple Terrace, FL 33637-0932
Mailing address
13214 Telecom Dr
Temple Terrace, FL 33637-0932
Phone (813) 988-7489
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN14117 | FL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327449600000",
"number": "1023101805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13214 TELECOM DR",
"city": "TEMPLE TERRACE",
"state": "FL",
"postal_code": "336370932",
"telephone_number": "813-988-7489",
"fax_number": "813-977-7004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13214 TELECOM DR",
"city": "TEMPLE TERRACE",
"state": "FL",
"postal_code": "336370932",
"telephone_number": "813-988-7489",
"fax_number": "813-977-7004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITT",
"first_name": "BRIAN",
"middle_name": "RICHARD",
"name_prefix": "Dr.",
"credential": "DMD PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2012-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN14117",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Temple Terrace, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.