Connor William Witty, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

0438000460 Issued in VA

Practice address

2401 C Ave
Fort Lee, VA 24801

Phone

(571) 231-6006

NPI assigned

Jun 22, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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": "1498089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1649790536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 OLD POSTAL RD",
            "city": "COLD SPRING",
            "state": "NY",
            "postal_code": "105163755",
            "telephone_number": "473-674-4377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 C AVE",
            "city": "FORT LEE",
            "state": "VA",
            "postal_code": "24801",
            "telephone_number": "571-231-6006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1110 State Route 55 Ste 107",
            "address_purpose": "LOCATION",
            "city": "Lagrangeville",
            "state": "NY",
            "postal_code": "125405048",
            "country_code": "US",
            "telephone_number": "845-453-6318",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WITTY",
        "first_name": "CONNOR",
        "middle_name": "WILLIAM",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-22",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401415652",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "063842",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "VA",
            "license": "0438000460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Michael Wemyss, PA-C
• Christine Lynn Wetherbee, PHARM D
• Stephanie Louise Wheeler, MSW, LCSW, LCADC
• Cartesea Cobb Williams, LPN
• Claudis Andre' Williams Jr., PA
• Michael G. Wong, LCSW
• Amy S Woodfin
• Brady Lamont Yates, D.O.
• Janet Ann Zilai, M.D.

• Oral and Maxillofacial Surgery (Dentist) in Fort Lee, VA
• Providers in Fort Lee, VA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; 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.