Charles Wylie, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

WV2926 Issued in WV

Practice address

1589 Wheeling Ave
Glen Dale, WV 26038-1731

Phone

(304) 845-2480

Fax

(304) 845-9204

NPI assigned

Aug 11, 2006

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

Other identifiers 1

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 and National Provider Directory roles.

• Charles L. Wylie DDS Group

  • Dentist
  • Glen Dale, WV
  • NPI 1356557706
  NPD (past) Authorized official
• Patricia Estep-Wylie

  • Optometrist
  • Glen Dale, WV
  • NPI 1427342526
  NPD (past)

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1275544280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1589 WHEELING AVE",
            "city": "GLEN DALE",
            "state": "WV",
            "postal_code": "260381731",
            "telephone_number": "304-845-2480",
            "fax_number": "304-845-9204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1589 WHEELING AVE",
            "city": "GLEN DALE",
            "state": "WV",
            "postal_code": "260381731",
            "telephone_number": "304-845-2480",
            "fax_number": "304-845-9204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYLIE",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WV",
            "license": "WV2926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0133399000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wheeling Hospital, Inc.
• Terry L Williams, O.D.
• Brandon Daniel Wilson, M.D.
• James Sherrill Wilson, DDS
• Meredith Lynne Wycherley, APRN
• Patricia Estep Wylie, O.D.
• Jeffrey Tyler Yeater, FNP
• Brianne Young

• Dentist in Glen Dale, WV
• Providers in Glen Dale, WV by specialty
• Dentist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.