Charles Edward Witkowski Sr., DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DS004426 Issued in TN

Practice address

1021 W Oakland Ave
Suite 109
Johnson City, TN 37604-2191

Phone

(423) 283-4555

Fax

(423) 283-3044

NPI assigned

Jan 24, 2006

Last updated

Mar 11, 2014By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• The Regional Center for Oral & Maxillofacial Surgery, PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Johnson City, TN
  • NPI 1427163666
  Authorized official Same address or phone
• Johnson City Oral and Maxillofacial Surgery, LLC

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Johnson City, TN
  • NPI 1720601230
  NPD (past)

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394496000000",
    "number": "1588634471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5549",
            "address_2": "SUITE 109",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37602",
            "telephone_number": "423-283-4555",
            "fax_number": "423-283-3044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE",
            "address_2": "SUITE 109",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042191",
            "telephone_number": "423-283-4555",
            "fax_number": "423-283-3044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITKOWSKI",
        "first_name": "CHARLES",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2014-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "DS004426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blake Winkle
• Johnathan Myles Winstead, M.D.
• George Beverly Winton, MD
• Jennifer C. Wisdom-Schepers, MD
• Kayla Withrow
• Christopher Zachary Witkowski, APRN PMHNP-BC
• Rachel Marie Witt, PMHNP-BC
• Melissa A Witzigman, PA
• Fiona Esther Kate Wixon
• Ellie Wolf, DC

• Oral and Maxillofacial Surgery (Dentist) in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2014; 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.