Provider Demographics
NPI:1821799248
Name:WITT, FAITH MUMBUA JOSEPH (DDS)
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:MUMBUA JOSEPH
Last Name:WITT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:FAITH
Other - Middle Name:MUMBUA
Other - Last Name:JOSEPH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:457 SHADY SPRING DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43230-4388
Mailing Address - Country:US
Mailing Address - Phone:808-989-8587
Mailing Address - Fax:
Practice Address - Street 1:10677 US 15 501 HWY
Practice Address - Street 2:
Practice Address - City:SOUTHERN PINES
Practice Address - State:NC
Practice Address - Zip Code:28387-5154
Practice Address - Country:US
Practice Address - Phone:919-295-2757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-13
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC133431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice