Individual provider Active NPI

Bryan Wendell, DDS

  • Dentist
  • Yorktown, VA
National Provider Identifier
1619269172
Registry record updated Nov 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401413563 Issued in VA
Practice address
113 Hampton Hwy
Yorktown, VA 23693-3510
Phone
(757) 867-8765
NPI assigned
May 3, 2011
Last updated
Nov 1, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401413563 VA Primary

Addresses

Primary practice location

113 Hampton Hwy
Yorktown, VA 23693-3510

Mailing address

113 Hampton Hwy
Yorktown, VA 23693-3510
Phone (757) 867-8765

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20150730013479 VA Order and Referring Only - DentistPractitioner - Dentist 7719291038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Two Rivers Family and Cosmetic Dentistry PastSince Nov 18, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1304380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761955200000",
    "number": "1619269172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 HAMPTON HWY",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "236933510",
            "telephone_number": "757-867-8765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 HAMPTON HWY",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "236933510",
            "telephone_number": "757-867-8765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENDELL",
        "first_name": "BRYAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-03",
        "last_updated": "2025-11-01",
        "certification_date": "2025-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401413563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yorktown, VA

Sources for this page

Verify at the official NPI Registry.