Garrett Dewolf, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D11881 Issued in OR

Practice address

23Rd Dental Company 1591 Griffin Road
Twentynine Palms, CA 92278

Phone

(760) 830-7054

NPI assigned

Sep 5, 2023

Last updated

Sep 5, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1693872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1992581151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23RD DENTAL COMPANY 1591 GRIFFIN ROAD",
            "city": "TWENTYNINE PALMS",
            "state": "CA",
            "postal_code": "92278",
            "telephone_number": "760-830-7054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23RD DENTAL COMPANY 1591 GRIFFIN ROAD",
            "city": "TWENTYNINE PALMS",
            "state": "CA",
            "postal_code": "92278",
            "telephone_number": "760-830-7054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWOLF",
        "first_name": "GARRETT",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-05",
        "last_updated": "2023-09-05",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D11881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kannitha Makayla-Lee Davila, BA, BS
• James Elbert Davis, AU.D.
• Ada Chelan Dee, APRN
• Brianna Danielle Dennison
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• Jacquelynn J Diaz
• Jennifer Diemart, M.A.
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• Casey Grace Dixon, PA-C
• Mikhailpietro Drilon

• General Practice Dentistry in Twentynine Palms, CA
• Providers in Twentynine Palms, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.

Verify at the official NPI Registry.