Healthcare Provider Details

I. General information

NPI: 1972417665
Provider Name (Legal Business Name): WENDY ROSE-HYATT, DDS., PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 WILLIAMS CT STE 110
MIDDLE RIVER MD
21220-2890
US

IV. Provider business mailing address

405 WILLIAMS CT STE 110
MIDDLE RIVER MD
21220-2890
US

V. Phone/Fax

Practice location:
  • Phone: 410-687-2777
  • Fax: 410-687-3800
Mailing address:
  • Phone: 410-687-2777
  • Fax: 410-687-3800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number StateNULL

VIII. Authorized Official

Name: WENDY ROSE-HYATT
Title or Position: OWNER
Credential: DDS
Phone: 410-687-2777