Dr Jay B Wettstein DMD PC

Primary specialty

DentistTaxonomy code 122300000X

License

D7219 Issued in OR

Legal business name

DR JAY B WETTSTEIN DMD PC

Practice address

478 SW 12TH St
Ontario, OR 97914

Phone

(541) 889-6666

Fax

(541) 889-2904

NPI assigned

Oct 26, 2007

Last updated

Oct 26, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Pamela Wettstein

Title

Officer

Phone

(541) 889-6666

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193356800000",
    "number": "1871772814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "478 SW 12TH ST",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "97914",
            "telephone_number": "541-889-6666",
            "fax_number": "541-889-2904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "478 SW 12TH ST",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "97914",
            "telephone_number": "541-889-6666",
            "fax_number": "541-889-2904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR JAY B WETTSTEIN DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-26",
        "last_updated": "2007-10-26",
        "status": "A",
        "authorized_official_last_name": "WETTSTEIN",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "541-889-6666"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D7219",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D8990",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209473",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "804186800",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Ontario, OR
• Providers in Ontario, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; 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.