Andrew Thomas Wiswall, D.D.S

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

D0827 Issued in SD

Practice address

2333 W 57TH St
Suite 103
Sioux Falls, SD 57108-5053

Phone

(612) 208-7458

NPI assigned

Apr 6, 2010

Last updated

Aug 24, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wiswall Endodontics PC

  • Dental Clinic/Center
  • Sioux Falls, SD
  • NPI 1790182822
  Authorized official Same address or phone

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

{
    "created_epoch": "1270512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314144000000",
    "number": "1255656807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2333 W 57TH ST",
            "address_2": "SUITE 103",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571085053",
            "telephone_number": "612-208-7458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 W 57TH ST",
            "address_2": "SUITE 103",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571085053",
            "telephone_number": "612-208-7458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISWALL",
        "first_name": "ANDREW",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-06",
        "last_updated": "2011-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "SD",
            "license": "D0827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cassandra Wise
• Makaila Wise
• Wiseman Endodontics LLC
• Anne Elizabeth Wiseman, D.D.S., M.S.D.
• Wiswall Endodontics PC
• Brian T Wiswall, DDS
• Laura R Withorne-Maloney, CNP
• Kylee Anne Withrow, OTD
• Earl Gordon Witt, MA
• Lauren Witte, DDS, MS

• Endodontics in Sioux Falls, SD
• Providers in Sioux Falls, SD by specialty
• Endodontics in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.