Tianna Wallick

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DS044826 Issued in PA

Practice address

20440 Route 19
Cranberry TWP, PA 16066-7543

Phone

(724) 772-9688

NPI assigned

Mar 27, 2023

Last updated

Aug 25, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

State licenses

Practice roles

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.

• Dentistry for Kids

  • Dentist
  • Cranberry Township, PA
  • NPI 1013285998
  NPD (past)

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1386347425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20440 ROUTE 19",
            "city": "CRANBERRY TWP",
            "state": "PA",
            "postal_code": "160667543",
            "telephone_number": "724-772-9688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20440 ROUTE 19",
            "city": "CRANBERRY TWP",
            "state": "PA",
            "postal_code": "160667543",
            "telephone_number": "724-772-9688"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8620 Duncan Ave",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152375884",
            "country_code": "US",
            "telephone_number": "412-367-2250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLICK",
        "first_name": "TIANNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-27",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PA",
            "license": "DS044826",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marissa Vetica
• Lynn M Vissotski
• VP Counseling
• Wal-Mart Stores East, LP (Vision Center 30-1770)
• Tamara L Walczyk, RPH
• Glenn Wargo, LPC
• Amber Warmus
• Andrea Wary, MS CCC-SLP
• David W. Watkins, D.M.D.
• Wealth of Wellness PC

• Pediatric Dentistry in Cranberry TWP, PA
• Providers in Cranberry TWP, PA by specialty
• Pediatric Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2025; 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.