Amity M Wrolstad, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

D8653 Issued in OR

Practice address

2420 NW Professional Dr
Suite 150
Corvallis, OR 97330-3990

Phone

(541) 758-6587

Fax

(541) 758-6768

NPI assigned

Jan 5, 2007

Sex

Female

Sole proprietor

No

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

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430352000000",
    "number": "1619025996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6950 NE CAMPUS WAY",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971245611",
            "telephone_number": "503-952-2125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 NW PROFESSIONAL DR",
            "address_2": "SUITE 150",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303990",
            "telephone_number": "541-758-6587",
            "fax_number": "541-758-6768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WROLSTAD",
        "first_name": "AMITY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2015-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D8653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Myles Worsham
• Rachel Wortman
• Hannah Wright
• Signe Harrang Wright, PA-C
• William H Wright, PAC
• Veronica Wu, DO
• Adrian Wulff, LPC
• Nicole Dianne Wydra, PA-C
• Alexandre B Yacques, DO
• Jessica Dawn Yacques, APRN,FNP, PMHNP

• Dentist in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.