Wayne Nolan Wyatt, DDS MS

Primary specialty

DentistTaxonomy code 122300000X

License

5563 Issued in OK

Practice address

9840 E 81St St Ste 100
Tulsa, OK 74133-4583

Phone

(918) 496-1155

Fax

(918) 496-1167

NPI assigned

Aug 18, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wayne N. Wyatt, DDS, Ms, PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Tulsa, OK
  • NPI 1699025122
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595980800000",
    "number": "1013021039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9840 E 81ST ST STE 100",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741334583",
            "telephone_number": "918-496-1155",
            "fax_number": "918-496-1167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9840 E 81ST ST STE 100",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741334583",
            "telephone_number": "918-496-1155",
            "fax_number": "918-496-1167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "WAYNE",
        "middle_name": "NOLAN",
        "name_prefix": "Mr.",
        "credential": "DDS MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "OK",
            "license": "151",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "5563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200044110",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric Wayne Wyatt, DDS
• Kristine Danielle Wyatt, PA-C
• Meredith Wyatt, OT
• Rebecca Ann Wyatt, DDS
• Robin Gayle Wyatt
• Ashley Lynn Duvall Wyckoff, NBCC
• Carol M Wycoff, P.T.
• David Ralph Wycoff
• Sacha Wren Wycoff, RN
• Georgia A. Wykoff, LCSW

• Dentist in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Dentist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.