Stanley J Wyatt, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

4848 Issued in KY

Practice address

1330 S Broadway
Lexington, KY 40504-2737

Phone

(859) 252-5220

Fax

(859) 252-0405

NPI assigned

Jul 2, 2009

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Ky Dental Professional, PSC

  • Dentist
  • Lexington, KY
  • NPI 1013160522
  NPD (past)

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

{
    "created_epoch": "1246492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246492800000",
    "number": "1871722553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 S BROADWAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405042737",
            "telephone_number": "859-252-5220",
            "fax_number": "859-252-0405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 S BROADWAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405042737",
            "telephone_number": "859-252-5220",
            "fax_number": "859-252-0405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "STANLEY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-02",
        "last_updated": "2009-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "4848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia H. Wyatt
• Jammie Wyatt, CPSS
• Jennifer Wyatt, RD
• Katarina Wyatt
• Shannon M Wyatt, LPCC
• Stephen Wyatt, DMD
• Tatyana Wyatt, LMT
• Samuel Kenneth Wyman
• Tasha Wynn, CRNA
• Elizabeth Wynstra, CRNA

• Dentist in Lexington, KY
• Providers in Lexington, KY by specialty
• Dentist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2009; 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.