David D. Wyse, D.D.S., P.C.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

060001892 Issued in IL

Legal business name

DAVID D. WYSE, D.D.S., P.C.

Practice address

207 S Prospect Rd
Ste. 2
Bloomington, IL 61704-4905

Phone

(309) 663-6393

Fax

(309) 664-0366

NPI assigned

Mar 20, 2007

Organization subpart

No

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

Authorized official

Name

Dr. David D. Wyse, DDSNPI 1669506234

Title

Owner

Phone

(309) 663-6393

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Douglas Wyse, D.D.S.

  • General Practice Dentistry
  • Bloomington, IL
  • NPI 1669506234
  NPD (past) Authorized official
• Jay Wesley Chrisman, D.D.S.

  • General Practice Dentistry
  • Bloomington, IL
  • NPI 1609990845
  NPD (past)

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380758400000",
    "number": "1124143896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 S PROSPECT RD",
            "address_2": "STE. 2",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617044905",
            "telephone_number": "309-663-6393",
            "fax_number": "309-664-0366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 S PROSPECT RD",
            "address_2": "STE. 2",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617044905",
            "telephone_number": "309-663-6393",
            "fax_number": "309-664-0366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID D. WYSE, D.D.S., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2013-10-03",
        "status": "A",
        "authorized_official_last_name": "WYSE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-663-6393",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "060001892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel a Nord MD, Obstetrics and Gynecology
• Dawn Dannenbring-Carlson
• Danville Vamc
• Bhargavi Dasari
• Melissa S Daugherty
• Stephanie L Davingman, CADC, LCSW, LMFT
• Francesca Lucia Davis
• Jacelle Davis
• Jessalyn Davis
• Dawn Zywiec Professional Counseling, LLC

• Dental Clinic/Center in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2013; 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.