DEWITT FAMILY DENTISTRY P.C. (NPI# 1104987833) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104987833 |
| Entity Type | Organization |
| Organization Name | DEWITT FAMILY DENTISTRY P.C. |
| Practice Address |
923 6th Ave De Witt IA 52742-1330 |
| Practice Telephone | 5636599500 |
| Mailing Telephone | 5636599500 |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2008-07-22 |
| Authorized Official Name | DR. TRACI PAULSEN (OWNER) |
| Authorized Official Telephone | 5636599500 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
07800 | IA | Dental Providers |
| N | 1223G0001X |
Dentist Specialization: General Practice |
06566 | IA | Dental Providers |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
08332 | IA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0473173 | 05 | |
| IA | 0911644 | 05 | |
| IA | 0264440 | 05 |
| Street Address |
923 6TH AVE |
| City | DE WITT |
| State | IA |
| Zip Code | 52742-1330 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760974745 | Lauren Faye Schemmel | Dentist | 923 6th Ave, De Witt, IA 52742-1330 | 2018-06-05 |
| 1265641039 | Sarah J. Matkovich | Dentist | 923 6th Ave, De Witt, IA 52742-1330 | 2007-05-21 |
| 1811106677 | Traci Paulsen | Dentist | 923 6th Ave, De Witt, IA 52742-1330 | 2007-05-21 |
| 1174730311 | Randall A. Hunt | Dentist | 923 6th Ave, De Witt, IA 52742-1330 | 2007-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801400106 | Samantha Wagler | Dentist | 923 6th Avenue, Dewitt, IA 52742 | 2020-09-03 |
| 1760808810 | Tracy Lynn Weller | Physical Therapy Assistant | 1331 5th Ave., Dewitt, IA 52742 | 2014-03-13 |
| 1255599981 | Patricia Ann Sheil | Chiropractor | 604 10th Street, Dewitt, IA 52742 | 2008-05-29 |
| 1205847340 | Dewitt Pharmacy Inc | Pharmacy | 609 7th Ave, Dewitt, IA 52742 | 2006-08-11 |
| 1083105639 | Cram Chiropractic, Pllc | Chiropractor | 602 12th Street, De Witt, IA 52742 | 2018-05-18 |
| 1780904854 | Life Rx Inc | Pharmacy | 609 7th Ave, Dewitt, IA 52742 | 2010-06-10 |
| 1528281094 | Jennifer Joan Walker | Pharmacist | 629 6th Ave, Scott Thrifty White Drug, Dewitt, IA 52742 | 2007-04-11 |
| 1932263639 | James Harland Demong | Pharmacist | 629 6th Ave, Dewitt, IA 52742 | 2006-12-20 |
| 1114080603 | Patti Sue Rose Trenkamp | Pharmacist | 629 6th Ave, Dewitt, IA 52742 | 2006-12-18 |
| 1629131156 | Dennis C Bousselot | Pharmacist | 629 6th Ave, Dewitt, IA 52742 | 2006-12-18 |
| Find all providers in zip 52742 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124568993 | Jose Alvarez | Dentist | 3425 Erie Blvd E Ste 1, De Witt, NY 13214 | 2017-02-27 |
| 1508027038 | David Stubbs | Dentist | 3425 Erie Blvd E, De Witt, NY 13214-1635 | 2008-06-18 |
| 1740354729 | Jeffrey Scott Siegel | Dentist | 907 11th St, De Witt, IA 52742-1207 | 2006-11-20 |
| 1639108061 | Michael Frederick Miller | Dentist | 4311 E Genesee St, De Witt, NY 13214-2121 | 2006-06-30 |
| 1962992834 | Alexa Brady Ellingsen Roehrig | Dentist | 3425 Erie Blvd E, De Witt, NY 13214-1635 | 2018-05-15 |
| 1942432729 | Scott Codwise Dickinson | Dentist | 3425 Erie Blvd E, De Witt, NY 13214-1635 | 2009-08-13 |
| 1265641039 | Sarah J. Matkovich | Dentist | 923 6th Ave, De Witt, IA 52742-1330 | 2007-05-21 |
| 1811106677 | Traci Paulsen | Dentist | 923 6th Ave, De Witt, IA 52742-1330 | 2007-05-21 |
| 1174730311 | Randall A. Hunt | Dentist | 923 6th Ave, De Witt, IA 52742-1330 | 2007-05-17 |
| 1194870626 | Dewitt Dental Associates, PC | Dentist | 907 11th St, De Witt, IA 52742-1207 | 2007-01-24 |
| Find all providers in DE WITT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.