Jared M Wirth, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE60866016 Issued in WA

Practice address

275 SE Cabot Dr.
#B201
Oak Harbor, WA 98277

Phone

(360) 675-6404

NPI assigned

Aug 27, 2018

Last updated

Aug 27, 2018By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1285115329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 489",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982770489",
            "telephone_number": "360-914-7417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 SE CABOT DR.",
            "address_2": "#B201",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "98277",
            "telephone_number": "360-675-6404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "275 SE Cabot Dr Ste B201",
            "address_purpose": "LOCATION",
            "city": "Oak Harbor",
            "state": "WA",
            "postal_code": "982773755",
            "country_code": "US",
            "telephone_number": "360-675-6404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIRTH",
        "first_name": "JARED",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-27",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60866016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GENERAL DENTIST",
            "identifier": "DE60866016",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allyson Noelle Willson
• Carly N Wilson
• Nellie Wilson, LMT, LMP
• Derek Thomas Wirth, DMD
• Douglas Lee Wirth, DMD
• Frank Gino Wolfe
• Terrence C. Wong, MD
• Darin Jeffrey Worley
• Traci Worthley
• Mary R Wotring, MSW

• General Practice Dentistry in Oak Harbor, WA
• Providers in Oak Harbor, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.