Ryan C Wittwer, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

56989 Issued in CA

Practice address

4420 Town Center Blvd Ste 220
El Dorado Hills, CA 95762-7137

Phone

(916) 941-1122

Fax

(916) 941-1149

NPI assigned

Jun 23, 2005

Last updated

Sep 19, 2016By 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 2

Addresses

Other identifiers 1

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": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474243200000",
    "number": "1639175748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4420 TOWN CENTER BLVD STE 220",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957627137",
            "telephone_number": "916-941-1122",
            "fax_number": "916-941-1149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4420 TOWN CENTER BLVD STE 220",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957627137",
            "telephone_number": "916-941-1122",
            "fax_number": "916-941-1149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTWER",
        "first_name": "RYAN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2016-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "22134",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "56989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1723256-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Terrance R Williams
• Jazzmine Wilson
• Jordan Randolph Wilson
• Olivia Marie Wilson, MA, AMFT
• Taylor Wilson
• Storri Wolfe
• Jessica Wolff
• Christopher Wolny
• Katie Woodfill
• Lamarya Woods

• Pediatric Dentistry in El Dorado Hills, CA
• Providers in El Dorado Hills, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2016; 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.