Organization Active NPI

Michael Wynn and Associates LLC

  • Dentist
  • Tulsa, OK
National Provider Identifier
1215696364
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
MICHAEL WYNN AND ASSOCIATES LLC
Doing business as
Wynn Dentistry
Practice address
4608 S Harvard Ave Ste a
Tulsa, OK 74135-2913
Phone
(918) 742-7351
Fax
(918) 742-7352
NPI assigned
Dec 15, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Authorized official

Name
Michael Joseph Wynn, DDS
Title
Owner
Phone
(918) 742-7351

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

4608 S Harvard Ave Ste a
Tulsa, OK 74135-2913

Mailing address

4608 S Harvard Ave Ste a
Tulsa, OK 74135-2913
Phone (918) 742-7351

Other names 1

  • Wynn Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

4608 S Harvard Ave
Ste A
Tulsa, OK 74135
Phone (918) 742-7351

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1639526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639526400000",
    "number": "1215696364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4608 S HARVARD AVE STE A",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352913",
            "telephone_number": "918-742-7351",
            "fax_number": "918-742-7352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4608 S HARVARD AVE STE A",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352913",
            "telephone_number": "918-742-7351",
            "fax_number": "918-742-7352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL WYNN AND ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-15",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A",
        "authorized_official_last_name": "WYNN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-742-7351",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wynn Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; 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.