John Nelson Wynn III

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

Practice address

32389 Echo LN BLDG 10
San Diego, CA 92147-5196

Phone

(619) 524-4487

NPI assigned

Feb 10, 2021

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

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

{
    "created_epoch": "1612915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1366034316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2792 HORNET WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921066421",
            "telephone_number": "804-490-8485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32389 ECHO LN BLDG 10",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921475196",
            "telephone_number": "619-524-4487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNN",
        "first_name": "JOHN",
        "middle_name": "NELSON",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-10",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jake Wylie
• Justin Jay Wylie
• Yu Yun Sheng Wyman
• Lisa Michelle Wyneken, MSW, LCSW
• David D Wynn, D.D.S.
• Monique Wynn
• Eileen T. Wynne, DO
• Howard E Wynne, M.D.
• Julia Elizabeth Wynne, L.AC.
• Mary French Wynne

• Dental Hygienist in San Diego, CA
• Providers in San Diego, CA by specialty
• Dental Hygienist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.