Active NPI
Roth Wyatt Hinkle, DDS
- General Practice Dentistry
- Southlake, TX
National Provider Identifier
1932349503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 23840
- Practice address
- 201 Players Cir Ste 100
Southlake, TX 76092-6945 - Phone
- (214) 704-5179
- NPI assigned
- Feb 23, 2009
- Last updated
- May 18, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 23840 | TX | Primary |
Addresses
Primary practice location
201 Players Cir Ste 100
Southlake, TX 76092-6945
Mailing address
1006 Brazos Dr
Southlake, TX 76092-6024
Phone (214) 704-5179
Other names 1
- Roth Hinkle
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23840 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| James H Holt | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715990400000",
"number": "1932349503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1006 BRAZOS DR",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760926024",
"telephone_number": "214-704-5179"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 PLAYERS CIR STE 100",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760926945",
"telephone_number": "214-704-5179"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HINKLE",
"first_name": "ROTH",
"middle_name": "WYATT",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-02-23",
"last_updated": "2024-05-18",
"certification_date": "2024-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "23840",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ROTH",
"last_name": "HINKLE",
"credential": "DDS",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Southlake, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.