Active NPI
Thomas Witzenberger, D.D.S.
- Periodontics
- Springfield, MA
National Provider Identifier
1538273131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 12807
- Practice address
- 1795 Main St
Suite 202
Springfield, MA 01103-1077 - Phone
- (413) 739-5685
- Fax
- (413) 737-8209
- NPI assigned
- Aug 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 12807 | MA | Primary |
Addresses
Primary practice location
1795 Main St
Suite 202
Springfield, MA 01103-1077
Mailing address
38 Green Briar Dr
Suffield, CT 06078-2458
Phone (860) 386-6423
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12807 | MA | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anthony T Quinta DMD LLC | Periodontics | Past | Accepting new patients |
| DRS. Gold, Moini & Witzenberger, P.C. | Periodontics | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Periodontics
- Springfield, MA
- NPI 1275058919
-
- Periodontics
- Springfield, MA
- NPI 1235243817
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1538273131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38 GREEN BRIAR DR",
"city": "SUFFIELD",
"state": "CT",
"postal_code": "060782458",
"telephone_number": "860-386-6423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1795 MAIN ST",
"address_2": "SUITE 202",
"city": "SPRINGFIELD",
"state": "MA",
"postal_code": "011031077",
"telephone_number": "413-739-5685",
"fax_number": "413-737-8209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITZENBERGER",
"first_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "MA",
"license": "12807",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.