Daniela Valle Wyatt, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DL14708 Issued in MA

Practice address

119 Windsor St
Cambridge, MA 02139-3647

Phone

(617) 665-3990

Fax

(617) 665-3989

NPI assigned

Jun 23, 2021

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

Other names 1

• Miss Daniela Sampaio Valle Wyatt Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dwyatt99168@direct.challiance.masshiway.net

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.

• Cambridge Public Health Commission

  • General Acute Care Hospital
  • Cambridge, MA
  • NPI 1487603585
  NPD

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

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1942879820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 WINDSOR ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021393647",
            "telephone_number": "617-665-3990",
            "fax_number": "617-665-3989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 WINDSOR ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021393647",
            "telephone_number": "617-665-3990",
            "fax_number": "617-665-3989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "DANIELA",
        "middle_name": "VALLE",
        "name_prefix": "Mrs.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-23",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DL14708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELA",
            "last_name": "SAMPAIO VALLE WYATT",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Henry Wu, PHARMD
• Julie Wu, M.D.
• Kevin Yang Wu, MD
• Tina Wu
• Lewis David Wurgaft, PHD
• Sarah Wyka, FNP-C
• Nutchapon Xanthavanij, M.D.
• Tiago Costa Xavier, PHARMACY INTERN
• Joyce Xia, MD
• Xiaoyan Fan PHD LLC

• Dentist in Cambridge, MA
• Providers in Cambridge, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.

Verify at the official NPI Registry.