Don S Wyatt, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D-4052 Issued in ID

Practice address

138 Country LN Ste 1
Jerome, ID 83338-6147

Phone

(208) 324-8861

Fax

(208) 324-8899

NPI assigned

Jun 12, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Kevin L Hamblin DDS

  • Dentist
  • Twin Falls, ID
  • NPI 1760599963
  NPD (past)
• Mint Dental Care PLLC

  dba Mint Dental Care

  • General Practice Dentistry
  • Twin Falls, ID
  • NPI 1245064427
  NPD (past)

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1841494119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 COUNTRY LN STE 1",
            "city": "JEROME",
            "state": "ID",
            "postal_code": "833386147",
            "telephone_number": "208-324-8861",
            "fax_number": "208-324-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 COUNTRY LN STE 1",
            "city": "JEROME",
            "state": "ID",
            "postal_code": "833386147",
            "telephone_number": "208-324-8861",
            "fax_number": "208-324-8899"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "529 Broadway Ave S",
            "address_purpose": "LOCATION",
            "city": "Buhl",
            "state": "ID",
            "postal_code": "833161312",
            "country_code": "US",
            "telephone_number": "208-543-6511",
            "fax_number": "208-324-8899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYATT",
        "first_name": "DON",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-12",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D4052",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-4052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Wiley, OTR/L
• Catherine Marie Wilkerson
• Brayden Christopher Prier Wilkes
• William H Lloyd
• Marta E Wooldridge, MD
• Youth Interactive Prevention Services Inc
• Thomas Henry Zepeda, MD

• General Practice Dentistry in Jerome, ID
• Providers in Jerome, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.