Kent H Wyatt, DDS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

5837 Issued in AZ

Practice address

512 E Whitehouse Canyon Rd
Suite 120
Green Valley, AZ 85614-0550

Phone

(520) 625-6167

Fax

(520) 625-6169

NPI assigned

Sep 20, 2007

Last updated

Sep 20, 2007By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 27, 2020 through Oct 27, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Kent H. Wyatt, D.D.S., P.C.

  • Endodontics
  • Green Valley, AZ
  • NPI 1396705109
  NPD (past) Authorized official
• Barney D. Streit, D.D.S., P.C.

  • Dental Clinic/Center
  • Green Valley, AZ
  • NPI 1215195953
  NPD (past)
• Endodontic Specialists of Northeast Ok

  • Endodontics
  • Tulsa, OK
  • NPI 1790951614
  NPD (past)

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190246400000",
    "number": "1629264957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 E WHITEHOUSE CANYON RD",
            "address_2": "SUITE 120",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856140550",
            "telephone_number": "520-625-6167",
            "fax_number": "520-625-6169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 E WHITEHOUSE CANYON RD",
            "address_2": "SUITE 120",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856140550",
            "telephone_number": "520-625-6167",
            "fax_number": "520-625-6169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "KENT",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-20",
        "last_updated": "2007-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "AZ",
            "license": "5837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isaak Wise, DPT
• WM Michael Cochran MD PLLC
• Matthew Woolsey, L.AC.
• James D Wright, D.D.S.
• Erika M Wyatt, DDS
• Steven Yap, DDS
• Sherrylyn Young, MD
• Yuri a Talalaev
• Melinda Ann Zeimantz, NP

• Endodontics in Green Valley, AZ
• Providers in Green Valley, AZ by specialty
• Endodontics in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.