Mary Ellen Wynn, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30-01-5596 Issued in OH

Practice address

3650 Muddy Creek Rd
Suite 200
Cincinnati, OH 45238-2044

Phone

(513) 922-4221

Fax

(513) 922-5634

NPI assigned

Dec 29, 2005

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Mary Ellen Wynn, D.D.S.,LLC

  • General Practice Dentistry
  • Cincinnati, OH
  • NPI 1376769315
  NPD (past) Authorized official
• Ollom DDS Muddy Creek LLC

  • Dental Clinic/Center
  • Cincinnati, OH
  • NPI 1821751587
  NPD (past)

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1710964838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 MUDDY CREEK RD",
            "address_2": "SUITE 200",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452382044",
            "telephone_number": "513-922-4221",
            "fax_number": "513-922-5634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 MUDDY CREEK RD",
            "address_2": "SUITE 200",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452382044",
            "telephone_number": "513-922-4221",
            "fax_number": "513-922-5634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNN",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-29",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-01-5596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Wynn, QMHS
• Edward Wynn, LPC
• Laquinda Nicole Wynn, LPN
• Lindsay M Wynn
• Lisa A Wynn, LPN
• Ryane M Wynn
• Tamarah Lenise Wynn
• Tom M Wynn, RPH
• Tyler Matthew Wynn, DPT
• Thomas James Wynsen

• General Practice Dentistry in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.