Active NPI
Anthony David Emmanuel Wallitsch, DMD
- General Practice Dentistry
- Tampa, FL
National Provider Identifier
1649903824
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 27181
- Practice address
- 2702 W Hillsborough Ave
Tampa, FL 33614-6053 - Phone
- (813) 365-3021
- NPI assigned
- Jul 6, 2022
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 27181 | FL | Primary |
Addresses
Primary practice location
2702 W Hillsborough Ave
Tampa, FL 33614-6053
Mailing address
2702 W Hillsborough Ave
Tampa, FL 33614-6053
Phone (813) 365-3021
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27181 | FL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| TMJ & Sleep Center LLC | Past | Accepting new patients | |
| Imaging Institute LLC | Past | Accepting new patients |
Networks
- Freedom Health HMO Network
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.
-
- Diagnostic Radiology Physician
- Santa Rosa Beach, FL
- NPI 1740781137
-
- Dental Clinic/Center
- Santa Rosa Beach, FL
- NPI 1942764287
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687737600000",
"number": "1649903824",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2702 W HILLSBOROUGH AVE",
"city": "TAMPA",
"state": "FL",
"postal_code": "336146053",
"telephone_number": "813-365-3021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2702 W HILLSBOROUGH AVE",
"city": "TAMPA",
"state": "FL",
"postal_code": "336146053",
"telephone_number": "813-365-3021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLITSCH",
"first_name": "ANTHONY",
"middle_name": "DAVID EMMANUEL",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-07-06",
"last_updated": "2023-06-26",
"certification_date": "2023-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "27181",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.