Individual provider Active NPI

Davis Wesley Witt, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Holden, MA
National Provider Identifier
1497008460
Registry record updated Oct 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
17900 Issued in MA
Practice address
1406 Main St
Holden, MA 01520-1090
Phone
(508) 829-7650
Fax
(508) 829-4616
NPI assigned
Oct 16, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 17900 MA Primary

Addresses

Primary practice location

1406 Main St
Holden, MA 01520-1090

Mailing address

207 Mirick Rd
Princeton, MA 01541-1115
Phone (978) 464-5179

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

State licenses

LicenseStateTypeSpecialty
17900MAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Witt Orthodontics PC Orthodontics and Dentofacial Orthopedics Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1350345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350345600000",
    "number": "1497008460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 MIRICK RD",
            "city": "PRINCETON",
            "state": "MA",
            "postal_code": "015411115",
            "telephone_number": "978-464-5179",
            "fax_number": "508-829-4616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 MAIN ST",
            "city": "HOLDEN",
            "state": "MA",
            "postal_code": "015201090",
            "telephone_number": "508-829-7650",
            "fax_number": "508-829-4616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITT",
        "first_name": "DAVIS",
        "middle_name": "WESLEY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-16",
        "last_updated": "2012-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MA",
            "license": "17900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holden, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.

Verify at the official NPI Registry.