KATHLEEN ELISSA WIRTH DMD NPI 1700717048

NPI Information

  • NPI: 1700717048
  • Provider Name: KATHLEEN ELISSA WIRTH, DMD
  • Classification: Student in an Organized Health Care Education/Training Program - 390200000X
  • Entity Type: Individual
  • Address: 824 NE 19TH AVE
    FORT LAUDERDALE, FL
    ZIP 33304
  • Phone: (304) 303-3020

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NPI Details

Kathleen Elissa Wirth, DMD is a student in an organized health care education training program in Fort Lauderdale, FL. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Kathleen Elissa Wirth, DMD NPI is 1700717048. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

824 NE 19TH AVE
FORT LAUDERDALE, FL
ZIP 33304-081
Phone: (304) 303-3020

The enumeration date for this NPI number is 5/26/2026 and was last updated on 5/26/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1390200000XStudent in an Organized Health Care Education/Training ProgramFLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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