Brad Wyatt, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

26432 Issued in TX

Practice address

300 W Boyd Dr
Allen, TX 75013-2518

Phone

(972) 727-3941

Fax

(972) 727-4352

NPI assigned

Jan 3, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475798400000",
    "number": "1013064260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 65",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750130002",
            "telephone_number": "972-727-3941",
            "fax_number": "972-727-4352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W BOYD DR",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750132518",
            "telephone_number": "972-727-3941",
            "fax_number": "972-727-4352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "BRAD",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2016-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "26432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Florence Woods, LPC
• Elizabeth Parks Wooten, AU.D.
• Jimmie Nathan Wooten IV, D.C.
• Amanda M Worthy
• Shereta Wright
• Robert Marc Wycoff, MD
• Elizabeth Wylot, AUD
• James Wyrick, MD
• Albert Xiao, MD
• Enjia Xiong

• Dentist in Allen, TX
• Providers in Allen, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.