Irving Witonsky, DMD
Individual provider Active NPI Dentist · Houtzdale, PA
NPI 1366697146 · NPPES record last updated Nov 20, 2008
Key facts
- NPI
- 1366697146
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DS019451L (PA)
- Practice address
- 439 Spring St
Houtzdale, PA 16651-1702 - Phone
- (814) 378-7006
- NPI assigned
- Nov 20, 2008
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150610000891 | PA | Order and Referring Only - Dentist |
4981925310 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pierre Boumerhi DMD LLC | Dentist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS019451L | PA | Yes |
Addresses
Primary practice location
439 Spring St
Houtzdale, PA 16651-1702
Mailing address
1340 Zion Rd
Bellefonte, PA 16823-9138
Phone (570) 220-0188
Other providers in Houtzdale, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 20, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.