Wyatt Stephen Jones, DDS
Individual provider Active NPI Dentist · Machias, ME
NPI 1497484646 · NPPES record last updated Jun 5, 2022
Key facts
- NPI
- 1497484646
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 4954 (ME)
- Practice address
- 271 Main St
Machias, ME 04654-3606 - Phone
- (207) 255-8601
- NPI assigned
- Jun 5, 2022
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4954 | ME | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 4954 | ME | Yes |
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
Other providers in Machias, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 5, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.