Individual provider Active NPI

Patricia Lynn Fuhst Wylie, DDS

  • Dentist
  • Howell, MI
National Provider Identifier
1639371289
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
15032 Issued in MI
Practice address
416 E Grand River Ave
Howell, MI 48843-2325
Phone
(517) 546-3180
Fax
(517) 546-5824
NPI assigned
Jun 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 15032 MI Primary

Addresses

Primary practice location

416 E Grand River Ave
Howell, MI 48843-2325

Mailing address

416 E Grand River Ave
Howell, MI 48843-2325
Phone (517) 546-3180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20160303002507 MI Order and Referring Only - DentistPractitioner - Dentist 7517263320

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15032MIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639371289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 E GRAND RIVER AVE",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488432325",
            "telephone_number": "517-546-3180",
            "fax_number": "517-546-5824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 E GRAND RIVER AVE",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488432325",
            "telephone_number": "517-546-3180",
            "fax_number": "517-546-5824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUHST WYLIE",
        "first_name": "PATRICIA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "15032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Howell, MI

Sources for this page

Verify at the official NPI Registry.