Active NPI
Jeremy Wilhelm Wittich, DDS
- Pediatric Dentistry
- Seabrook, TX
National Provider Identifier
1710143433
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 0022616
- Practice address
- 906 Shorewood Drive
Seabrook, TX 77586 - Phone
- (646) 220-4429
- NPI assigned
- Aug 1, 2008
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 0022616 | TX | Primary |
| Pediatric Dentistry | 1223P0221X | DEN-9676 | CO |
Addresses
Primary practice location
906 Shorewood Drive
Seabrook, TX 77586
Mailing address
906 Shorewood Drive
Seabrook, TX 77586
Phone (646) 220-4429
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 |
|---|---|---|---|
| DEN-9676 | CO | MD | Pediatric Dentist |
| 0022616 | TX | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217548800000",
"number": "1710143433",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "906 SHOREWOOD DRIVE",
"city": "SEABROOK",
"state": "TX",
"postal_code": "77586",
"telephone_number": "646-220-4429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "906 SHOREWOOD DRIVE",
"city": "SEABROOK",
"state": "TX",
"postal_code": "77586",
"telephone_number": "646-220-4429"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITTICH",
"first_name": "JEREMY",
"middle_name": "WILHELM",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-08-01",
"last_updated": "2008-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "TX",
"license": "0022616",
"primary": true
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CO",
"license": "DEN-9676",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seabrook, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.