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DR. WYATT WILLIAM WILSON DMD
NPI 1023423639
Dentist - General Practice in Oregon City, OR

Active since June 23, 2014PECOS Enrolled
19029 BEAVERCREEK RD, OREGON CITY, OR 97045(503) 941-3064(503) 941-3075 Get Directions Write a Review

NPPES record last updated: April 20, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 20, 2020, Mar 17, 2018, Oct 23, 2017 (3 updates tracked since 2017).

About Dr. Wyatt William Wilson Dmd NPPES

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

DR. WYATT WILLIAM WILSON DMD (NPI 1023423639) is an individual general practice provider in Oregon City, Oregon, licensed in Oregon (D10058) and active in the NPI registry since June 2014. He is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1023423639
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. WYATT WILLIAM WILSONCredential: DMD
Location Address19029 BEAVERCREEK RDOregon City, OR 97045-9537
Mailing Address7320 Sw Hunziker Rd Ste 300Portland, OR 97223-2302 · (503) 941-3077 · Fax (503) 747-7013
Phone(503) 941-3064
Fax(503) 941-3075
Sole ProprietorNo
Enumeration DateJune 23, 2014
Last NPPES UpdateApril 20, 20203 updates tracked since enumeration
NPPES CertifiedApril 20, 2020
✔ NPI 1023423639 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in OR · D10058
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
19029 BEAVERCREEK RD, Oregon City, OR 97045
Open in Google Maps ↗

Secondary Practice Locations 2

Location 13300 SE Dwyer Dr Ste 302Milwaukie, OR 97222-6548 · Phone (503) 850-4479 · Fax (503) 850-4481
Location 218650 NW Cornell RdHillsboro, OR 97124-9207 · Phone (503) 848-5861 · Fax (503) 848-5863

Other Identifiers 1

Medicaid500675716OR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Wyatt William Wilson Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97045 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
$90.51 typical visit price
range $58.99 – $176.88
Typical copayment $22.62 (range $14.74 – $44.22)
Most-billed visit code 99203
Established Patient
$73.28 typical visit price
range $19.32 – $144.79
Typical copayment $18.32 (range $4.83 – $36.19)
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 6

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

RACHEL FRENCH
Dental Hygienist
19029 BEAVERCREEK RD
OREGON CITY, OR 97045
Clackamas County (503) 941-3064
DR. SEAN S KIM D.M.D
Dentist (General Practice)
19029 BEAVERCREEK RD
OREGON CITY, OR 97045
Clackamas County (503) 722-9184
MISS ALYNN VIENOT HAYES RDH, MPH
Dental Hygienist
19029 BEAVERCREEK RD
OREGON CITY, OR 97045
Clackamas County (503) 941-3064
KELLY ANSLEY RDH
Dental Hygienist
19029 BEAVERCREEK RD
OREGON CITY, OR 97045
Clackamas County (503) 941-3067
ESTHER RIOS RHD
Dental Hygienist
19029 BEAVERCREEK RD
OREGON CITY, OR 97045
Clackamas County (503) 941-3064
DR. JOSHUA M SMITH DDS
Dentist
19029 BEAVERCREEK RD
OREGON CITY, OR 97045
Clackamas County (503) 941-3064

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 Wyatt Wilson's NPI number?

The NPI number for Wyatt Wilson is 1023423639. It was assigned to this individual provider in the NPPES registry on June 23, 2014.

Where is Wyatt Wilson located?

Wyatt Wilson practices at 19029 Beavercreek Rd, Oregon City, OR 97045. The listed phone number is (503) 941-3064.

What is Wyatt Wilson's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Wyatt Wilson enrolled in Medicare?

Yes. Wyatt Wilson is registered in the Medicare PECOS enrollment system.

What insurance does Wyatt Wilson accept?

Health plans from BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Delta Dental Plan of Oregon and 3 other insurers list Wyatt Wilson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Wyatt Wilson was last updated on April 20, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.