Judith L Wybenga, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

18126 Issued in MI

Practice address

305 E Broadway St
Mt Pleasant, MI 48858-2647

Phone

(989) 779-8747

Fax

(989) 953-4037

NPI assigned

Jan 24, 2007

Sex

Female

Sole proprietor

Yes

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 MI

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

State licenses

Practice roles

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.

• Michael Frances Lahey DDS

  dba Four seasons Dental Associates

  • General Practice Dentistry
  • Lake City, MI
  • NPI 1245848738
  NPD (past)
• Ryan M. Hills, DDS, PLC

  • General Practice Dentistry
  • Mt Pleasant, MI
  • NPI 1609445030
  NPD (past)

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1073668729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3609 BUCK DR",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488588820",
            "telephone_number": "989-779-8747",
            "fax_number": "989-953-4037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 E BROADWAY ST",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488582647",
            "telephone_number": "989-779-8747",
            "fax_number": "989-953-4037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYBENGA",
        "first_name": "JUDITH",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "18126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luke Worgess
• Eleanor Madeline Workman, LLPC
• Felicia Wright
• Joanna Wright
• Mary Katherine Wright
• Alisha Wymer-Shattuck
• Kimberly Kay Wyse
• Abigail Marie Yancer
• Christian Zared Yaw
• Vicki Lee Yazzie, BA, LBSW, QMHP,QMRP,

• General Practice Dentistry in Mt Pleasant, MI
• Providers in Mt Pleasant, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; 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.