Active NPI
Robert Joseph Wygonski, DMD
- Oral and Maxillofacial Surgery (Dentist)
- Hyannis, MA
National Provider Identifier
1699725788
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 19609
- Practice address
- 700 Attucks Lane
Ste 2-E
Hyannis, MA 02601 - Phone
- (508) 775-5676
- Fax
- (508) 775-4163
- NPI assigned
- May 11, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 19609 | MA | Primary |
Addresses
Primary practice location
700 Attucks Lane
Ste 2-E
Hyannis, MA 02601
Mailing address
700 Attucks Lane
Ste 2-E
Hyannis, MA 02601
Phone (508) 775-5676
Other identifiers 14
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 19609 | Other | MA | DELTA DENTAL |
| 19609 | Other | TUFTS MEDICAL | |
| X07807 | Other | MA | BCBS DENTAL MEDICAL GRP |
| 1960950 | Other | CIGNA DENTAL | |
| 351151 | Other | UNITED HEALTH CARE DENTAL | |
| 554390 | Other | CIGNA MEDICAL | |
| X11480 | Other | MA | BCBS DENTAL MEDICAL GRP |
| 043462388 | Other | TAX ID | |
| 280425 | Other | US HEALTHCARE | |
| 3318505 | Other | TRI CARE MEDICAL | |
| 152228 | Other | HARVARD PILGRIM MEDICAL | |
| 19609 | Other | MA | DENTAL LICENSE NUMBER |
| 1672037 | Other | UNITED CONCORDIA DENTAL | |
| 2804025 | Other | AETNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19609 | MA | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344556800000",
"number": "1699725788",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 ATTUCKS LANE",
"address_2": "STE 2-E",
"city": "HYANNIS",
"state": "MA",
"postal_code": "02601",
"telephone_number": "508-775-5676",
"fax_number": "508-775-4163"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 ATTUCKS LANE",
"address_2": "STE 2-E",
"city": "HYANNIS",
"state": "MA",
"postal_code": "02601",
"telephone_number": "508-775-5676",
"fax_number": "508-775-4163"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYGONSKI",
"first_name": "ROBERT",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-11",
"last_updated": "2012-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "MA",
"license": "19609",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DELTA DENTAL",
"identifier": "19609",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS MEDICAL",
"identifier": "19609",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS DENTAL MEDICAL GRP",
"identifier": "X07807",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA DENTAL",
"identifier": "1960950",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE DENTAL",
"identifier": "351151",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA MEDICAL",
"identifier": "554390",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS DENTAL MEDICAL GRP",
"identifier": "X11480",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "043462388",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "US HEALTHCARE",
"identifier": "280425",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRI CARE MEDICAL",
"identifier": "3318505",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM MEDICAL",
"identifier": "152228",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL LICENSE NUMBER",
"identifier": "19609",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA DENTAL",
"identifier": "1672037",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "2804025",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Hyannis, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.