MEDICARE: JOAN Z WITT, DDS & ASSOCIATES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DS023626L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	WI453495	OTHER	PA	UNITED CONCORDIA PROVIDER
2	23626PA	OTHER	PA	DELTADENTAL OF PA

General Provider Information

NPI Number	:	1023102217
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOAN Z WITT, DDS & ASSOCIATES, INC

Provider Business Mailing Address
First Line	:	250 MOUNT LEBANON BLVD
Second Line	:	SUITE 201
City	:	PITTSBURGH
State	:	PA
Zip	:	15234-1252
Country	:	US
Telephone Number	:	412-344-7755
Fax Number	:

Provider Business Practice Location Address
First Line	:	250 MOUNT LEBANON BLVD
Second Line	:	SUITE 201
City	:	PITTSBURGH
State	:	PA
Zip	:	15234-1252
Country	:	US
Telephone Number	:	412-344-7755
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JOAN Z WITT
Credential	:	DDS
Telephone Number	:	412-344-7755

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	05/27/2010

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