Cherylin H Wyatt, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

58495 Issued in CA

Practice address

1100 Sonoma Ave Ste B
Santa Rosa, CA 95405-8901

Phone

(707) 546-3791

Fax

(707) 546-9732

NPI assigned

Jul 31, 2009

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Wyatt Dental Corporation

  • Dentist
  • Santa Rosa, CA
  • NPI 1184038929
  NPD Authorized official

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

{
    "created_epoch": "1248998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1811128374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 SONOMA AVE STE B",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954058901",
            "telephone_number": "707-546-3791",
            "fax_number": "707-546-9732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 SONOMA AVE STE B",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954058901",
            "telephone_number": "707-546-3791",
            "fax_number": "707-546-9732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "CHERYLIN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-31",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "58495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Wu, DDS
• Wei Der Wu, M.D.
• Sophia Rose Wuest
• Heidi Wurzburg, RN, MSN, FNP
• Wyatt Dental Corporation
• Angela Wyble, PAC
• Ashleigh Wylie
• Catherine Wynia, M.A.
• Jeffrey Y Xu, MD
• Songyi Xu, PHARMD

• General Practice Dentistry in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.