DR. GARY L WYATT DDS
NPI 1003978602
Dentist - Oral and Maxillofacial Surgery in Costa Mesa, CA

Q: What is Gary Wyatt's NPI number?

The NPI number for Gary Wyatt is 1003978602. It was assigned to this individual provider in the NPPES registry on December 14, 2006.

Q: What is Gary Wyatt's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Q: Is Gary Wyatt enrolled in Medicare?

No. Gary Wyatt has opted out of Medicare through June 21, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Gary Wyatt was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 14, 2006Opted out of Medicare · through Jun 21, 2028

1801 NEWPORT BOULEVARD, SUITE C, COSTA MESA, CA 92627(949) 650-1030(949) 722-2481 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Gary L Wyatt Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. GARY L WYATT DDS (NPI 1003978602) is an individual oral and maxillofacial surgery provider in Costa Mesa, California, licensed in California (22313) and active in the NPI registry since December 2006. He has opted out of Medicare through June 21, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1003978602

Entity TypeIndividualMale

Primary Taxonomy1223S0112X

Provider Legal NameDR. GARY L WYATTCredential: DDS

Location Address1801 NEWPORT BOULEVARD, SUITE CCosta Mesa, CA 92627

Mailing Address1401 Avocado Avenue, Suite 506Newport Beach, CA 92660 · (949) 760-1661 · Fax (949) 760-8016

Phone(949) 650-1030

Fax(949) 722-2481

Sole ProprietorNo

Enumeration DateDecember 14, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1003978602 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers

Taxonomy Code1223S0112X

License✔ Licensed in CA · 22313

Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

1801 NEWPORT BOULEVARD, Costa Mesa, CA 92627

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Other Identifiers 1

Medicare UPINT08341

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Gary L Wyatt Dds has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from June 21, 2016 through June 21, 2028.

Opt-Out Effective DateJune 21, 2016

Opt-Out In Effect ThroughJune 21, 2028Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92627 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$77.96 typical visit price

range $20.84 – $153.61

Typical copayment $19.49 (range $5.21 – $38.40)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. THOMAS R MICHAELIS DDS MD

Dentist (Oral and Maxillofacial Surgery)

1801 NEWPORT BOULEVARD, SUITE C
COSTA MESA, CA 92627

Orange County (949) 650-1030

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gary Wyatt's NPI number?

The NPI number for Gary Wyatt is 1003978602. It was assigned to this individual provider in the NPPES registry on December 14, 2006.

Where is Gary Wyatt located?

Gary Wyatt practices at 1801 Newport Boulevard Suite C, Costa Mesa, CA 92627. The listed phone number is (949) 650-1030.

What is Gary Wyatt's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Gary Wyatt enrolled in Medicare?

No. Gary Wyatt has opted out of Medicare through June 21, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Gary Wyatt was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.