Brian L Wyche, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

73368 Issued in OK

Practice address

1305 East Kirk
Hugo, OK 74743

Phone

(580) 326-9631

Fax

(580) 326-5440

NPI assigned

Apr 3, 2007

Reactivated

Sep 5, 2007

Last updated

Sep 5, 2007By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Purify Dental of Hugo PLLC

  dba New Image Dental of Hugo

  • Dental Clinic/Center
  • Hugo, OK
  • NPI 1568251635
  NPD (past)
• Steven M Deaton, DDS, PC

  dba Newimage Dental of Hugo

  • Dentist
  • Hugo, OK
  • NPI 1134381809
  NPD (past)

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188950400000",
    "number": "1154442572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 EAST KIRK",
            "city": "HUGO",
            "state": "OK",
            "postal_code": "74743",
            "telephone_number": "580-326-9631",
            "fax_number": "580-326-5440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 EAST KIRK",
            "city": "HUGO",
            "state": "OK",
            "postal_code": "74743",
            "telephone_number": "580-326-9631",
            "fax_number": "580-326-5440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYCHE",
        "first_name": "BRIAN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-09-05",
        "deactivation_date": "2007-07-17",
        "reactivation_date": "2007-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "73368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Wray Wisener
• Tony Len Womack, BHRS
• Patricia Wood
• Casey J Woolsey, CNP
• Elizabeth Wulf
• X-Zact Therapy & Aquatics of Hugo
• Angelia Dawn Yandell
• Adeline Youngblood, M.B.S., L.P.C.C
• Alicia Younger
• Younique Therapy

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2007; 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.