Wyatt Dental Group, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

WYATT DENTAL GROUP, LLC

Practice address

5037 Veterans Memorial Blvd
Ste 3E
Metairie, LA 70006-5136

Phone

(504) 885-1039

Fax

(504) 885-2028

NPI assigned

Apr 22, 2010

Organization subpart

Yes

Parent organization

LISA WYATT, D.D.S.As reported in NPPES

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

Authorized official

Name

Dr. Lisa Wyatt, DDS

Title

Owner/Dentist

Phone

(504) 885-1039

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1271894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271894400000",
    "number": "1780901355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5037 VETERANS MEMORIAL BLVD",
            "address_2": "STE 3E",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "70006",
            "telephone_number": "504-885-1039",
            "fax_number": "504-885-2028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5037 VETERANS MEMORIAL BLVD",
            "address_2": "STE 3E",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700065136",
            "telephone_number": "504-885-1039",
            "fax_number": "504-885-2028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYATT DENTAL GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LISA WYATT, D.D.S.",
        "enumeration_date": "2010-04-22",
        "last_updated": "2010-04-22",
        "status": "A",
        "authorized_official_last_name": "WYATT",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "504-885-1039",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Wright
• Claire Ashley Wroblewski
• Sarah Wroblewski, P-LPC, NCC, M.A,
• Ruth Wrubleski, SLP
• Lisa Pate Wursteisen, OT
• David Raymond Wyatt, BCO
• Lisa Wyatt, R.D.H.,B.S.,D.D.S.
• Kymbrehia Wynn
• Abigail Rose Wypyszinski
• Megan Nicole Wysocki, OTR/L

• General Practice Dentistry in Metairie, LA
• Providers in Metairie, LA by specialty
• General Practice Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2010; 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.