NPIMap

Organization Active NPI

James V. Wyllie, DDS P.C.

  • General Practice Dentistry
  • Newport, VT
National Provider Identifier
1760695597
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
652 Issued in VT
Legal business name
JAMES V. WYLLIE, DDS P.C.
Practice address
212 Prouty Dr
Suite 1
Newport, VT 05855-9851
Phone
(802) 334-6965
Fax
(802) 334-6606
NPI assigned
May 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. James Vincent Wyllie, D.D.S.NPI 1063595668
Title
Owner
Phone
(802) 334-6965

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 652 VT Primary

Addresses

Primary practice location

212 Prouty Dr
Suite 1
Newport, VT 05855-9851

Mailing address

212 Prouty Dr
Suite 1
Newport, VT 05855-9851
Phone (802) 334-6965

Other identifiers 1

IdentifierTypeStateIssuer
000-1845MedicaidVT

Other names 1

  • Birchwood Dental Associates Other name

National Provider Directory

National Provider Directory

Locations

212 Prouty Dr
Ste 1
Newport, VT 05855
Phone (802) 334-6965

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760695597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 PROUTY DR",
            "address_2": "SUITE 1",
            "city": "NEWPORT",
            "state": "VT",
            "postal_code": "058559851",
            "telephone_number": "802-334-6965",
            "fax_number": "802-334-6606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 PROUTY DR",
            "address_2": "SUITE 1",
            "city": "NEWPORT",
            "state": "VT",
            "postal_code": "058559851",
            "telephone_number": "802-334-6965",
            "fax_number": "802-334-6606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES V. WYLLIE, DDS P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WYLLIE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "VINCENT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "802-334-6965",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "VT",
            "license": "652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000-1845",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Birchwood Dental Associates",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Newport, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.