Grant Steven Titze, DDS PC

Primary specialty

DentistTaxonomy code 122300000X

License

M590 Issued in SD

Practice address

20 19TH St SE
Watertown, SD 57201-3938

Phone

(605) 886-2805

Fax

(605) 886-8357

NPI assigned

Feb 1, 2007

Last updated

May 17, 2021By 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

Electronic endpoints 2

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": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1538207758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 19TH ST SE",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572013938",
            "telephone_number": "605-886-2805",
            "fax_number": "605-886-8357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 19TH ST SE",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572013938",
            "telephone_number": "605-886-2805",
            "fax_number": "605-886-8357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TITZE",
        "first_name": "GRANT",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "DDS PC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SD",
            "license": "M590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Watertown",
            "affiliation": "N",
            "address_1": "20 19th St SE",
            "city": "Watertown",
            "state": "SD",
            "country_code": "US",
            "postal_code": "572013938",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Watertown",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "20 19th St SE",
            "city": "Watertown",
            "state": "SD",
            "country_code": "US",
            "postal_code": "572013938",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; 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.