Healthcare Provider Details

I. General information

NPI: 1720712938
Provider Name (Legal Business Name): C.W. VITTITOW DMD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2022
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2219 RIMLAND DR STE 110
BELLINGHAM WA
98226-8661
US

IV. Provider business mailing address

2520 VALLETTE STREET
BELLINGHAM WA
98225
US

V. Phone/Fax

Practice location:
  • Phone: 360-543-8488
  • Fax:
Mailing address:
  • Phone: 502-523-3514
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. CHARLES W VITTITOW
Title or Position: OWNER
Credential: DMD
Phone: 502-523-3514