Individual provider Active NPI

Wyatt Stephen Jones, DDS

  • Dentist
  • Machias, ME
National Provider Identifier
1497484646
Registry record updated Jun 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4954 Issued in ME
Practice address
271 Main St
Machias, ME 04654-3606
Phone
(207) 255-8601
NPI assigned
Jun 5, 2022
Last updated
Jun 5, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 4954 ME Primary

Addresses

Primary practice location

271 Main St
Machias, ME 04654-3606

Mailing address

215 W Shore Rd
Sorrento, ME 04677-3201
Phone (918) 931-0937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4954MEMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1654387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654387200000",
    "number": "1497484646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 W SHORE RD",
            "city": "SORRENTO",
            "state": "ME",
            "postal_code": "046773201",
            "telephone_number": "918-931-0937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "271 MAIN ST",
            "city": "MACHIAS",
            "state": "ME",
            "postal_code": "046543606",
            "telephone_number": "207-255-8601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "WYATT",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-05",
        "last_updated": "2022-06-05",
        "certification_date": "2022-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ME",
            "license": "4954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Machias, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2022; 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.