NPIMap

Organization Active NPI

Sean L Wittmer DMD PS

  • Endodontics
  • Tacoma, WA
National Provider Identifier
1649504606
Registry record updated Sep 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
7882 Issued in WA
Legal business name
SEAN L WITTMER DMD PS
Practice address
10904 Gravelly Lake Dr SW
Tacoma, WA 98499-1330
Phone
(253) 589-3636
NPI assigned
Sep 23, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2009

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

Authorized official

Name
Sean WittmerNPI 1871670430
Title
President
Phone
(253) 589-3636

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X 7882 WA Primary

Addresses

Primary practice location

10904 Gravelly Lake Dr SW
Tacoma, WA 98499-1330

Mailing address

10904 Gravelly Lake Dr SW
Tacoma, WA 98499-1330

National Provider Directory

National Provider Directory

Locations

10904 Gravelly Lake Dr SW
Tacoma, WA 98499
Phone (253) 589-3636

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1253664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253664000000",
    "number": "1649504606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10904 GRAVELLY LAKE DR SW",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984991330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10904 GRAVELLY LAKE DR SW",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984991330",
            "telephone_number": "253-589-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEAN L WITTMER DMD PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-23",
        "last_updated": "2009-09-23",
        "status": "A",
        "authorized_official_last_name": "WITTMER",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "253-589-3636"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "WA",
            "license": "7882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2009; 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.