Dennis Jon Wyman, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

161632-1205 Issued in UT

Practice address

175 W 200 S
Ste 4009
Salt Lake City, UT 84101-1413

Phone

(801) 359-7756

NPI assigned

Jul 15, 2005

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)

Enrolled

Credentials

Doctor of Medicine

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.

• Dennis J. Wyman M.D.

  • General Practice Physician
  • Salt Lake City, UT
  • NPI 1184753014
  NPD (past) Authorized official

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192492800000",
    "number": "1316946015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 W 200 S",
            "address_2": "STE 4009",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841011413",
            "telephone_number": "801-359-7756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 W 200 S",
            "address_2": "STE 4009",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841011413",
            "telephone_number": "801-359-7756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYMAN",
        "first_name": "DENNIS",
        "middle_name": "JON",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2007-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "UT",
            "license": "161632-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Ann Wuthrich
• Jason Floyd Wyasket, RN
• Tyler Wayne Wyatt, O.D.
• Whitney Wyatt
• Katherine Wycoff, OTR/L
• Bret Wynder, PHARMD
• Esther Wynder
• Jacqueline A Wynder
• Brian Wyrowski
• Corinne Xanthos, DPT

• General Practice Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• General Practice Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.