NPIMap

Organization Active NPI

J.Michael Wyatt Inc.P.C.

  • Point of Service
  • Oklahoma City, OK
National Provider Identifier
1780858654
Registry record updated Apr 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
License
4910 Issued in OK
Legal business name
J.MICHAEL WYATT INC.P.C.
Practice address
736 NW 63Rd St
Oklahoma City, OK 73116-7602
Phone
(405) 842-0033
Fax
(405) 842-0045
NPI assigned
Apr 22, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2008

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

Authorized official

Name
Dr. Jerry Michael Wyatt, D.D.S.
Title
President/Dentist
Phone
(405) 842-0033

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X 4910 OK Primary

Addresses

Primary practice location

736 NW 63Rd St
Oklahoma City, OK 73116-7602

Mailing address

736 NW 63Rd St
Oklahoma City, OK 73116-7602
Phone (405) 842-0033

Other identifiers 1

IdentifierTypeStateIssuer
1134252695OtherOKJ.MICHAEL WYATT INC.,P.C.

National Provider Directory

National Provider Directory

Locations

736 NW 63rd St
Oklahoma City, OK 73116
Phone (405) 842-0033

NPI Registry JSON

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208822400000",
    "number": "1780858654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 NW 63RD ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731167602",
            "telephone_number": "405-842-0033",
            "fax_number": "405-842-0045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 NW 63RD ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731167602",
            "telephone_number": "405-842-0033",
            "fax_number": "405-842-0045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J.MICHAEL WYATT INC.P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-22",
        "last_updated": "2008-04-22",
        "status": "A",
        "authorized_official_last_name": "WYATT",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT/DENTIST",
        "authorized_official_telephone_number": "405-842-0033",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "OK",
            "license": "4910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "J.MICHAEL WYATT INC.,P.C.",
            "identifier": "1134252695",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; 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.