Individual provider Active NPI

Daniel S Witcher, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • San Diego, CA
National Provider Identifier
1932352796
Registry record updated Jun 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
58080 Issued in CA
Practice address
4747 Orten St
San Diego, CA 92110-1322
Phone
(805) 407-6949
NPI assigned
Oct 24, 2008
Last updated
Jun 6, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 58080 CA Primary

Addresses

Primary practice location

4747 Orten St
San Diego, CA 92110-1322

Mailing address

4747 Orten St
San Diego, CA 92110-1322
Phone (805) 407-6949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150311001095 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9638495559

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
58080CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dwitcher42362@scrippshlth.medalliesdirect.net

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1224806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402012800000",
    "number": "1932352796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4747 ORTEN ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921101322",
            "telephone_number": "805-407-6949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4747 ORTEN ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921101322",
            "telephone_number": "805-407-6949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITCHER",
        "first_name": "DANIEL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-24",
        "last_updated": "2014-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "58080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.