Jennifer H Wynn, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

39456 Issued in CA

Practice address

10697 N Frank Lloyd Wright Blvd
Suite 102
Scottsdale, AZ 85259-2680

Phone

(831) 235-1003

NPI assigned

Mar 2, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481155200000",
    "number": "1144359720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10697 N FRANK LLOYD WRIGHT BLVD",
            "address_2": "SUITE 102",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852592680",
            "telephone_number": "831-235-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10697 N FRANK LLOYD WRIGHT BLVD",
            "address_2": "SUITE 102",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852592680",
            "telephone_number": "831-235-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNN",
        "first_name": "JENNIFER",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2016-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "39456",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D009624",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Xiaojun Wu, M.D., PHD
• Shelby Wullkotte
• Karen A. Wyckoff, O.D.
• Paul Jason Wyer, LMT
• Joshua Harold Wyler, PA-C
• Wyoming Urgent Care Provider Network, LLC
• Aaron J Wyse, M.D.
• Maria Christine Wytko, DMD
• Xcel Sports Clinic
• Jinsong Xiao

• General Practice Dentistry in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2016; 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.