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Deactivated NPI 1215167564 Deactivated / Inactive NPI Male Practitioner

Dr. George Habeeb Wyshak , DMD

Dentist • Boulder, CO

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. George Wyshak has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 21, 2009
NPI Deactivation Date June 05, 2025
Total Practice Duration ~16 Years of Practice (2009 – 2025)

Professional Overview & Biography Verified Profile Summary

Dr. George Wyshak, DMD was a registered Dentist practicing in Boulder, CO. Throughout an active medical career spanning 16 years, Dr. Wyshak provided care at the practice location at 6966 HARVEST RD until profile deactivation on 2025-06-05.

Practice Location & Contact Primary Location

Practice Address

6966 Harvest Rd

Boulder, CO 803013659

Telephone 3035301310
Fax 3035302999

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Boulder, CO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 9.2 Yrs
Regional Practice Density
43 Specialists

Practicing in Boulder, CO (2100 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License MA 8811

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated June 05, 2025

Record deactivated on June 05, 2025

NPI Profile Active July 21, 2009

NPI status registered as active in NPPES database

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Updated Practice Location July 21, 2009

Registered at 6966 HARVEST RD, BOULDER, CO 803013659 (Tel: 3035301310)

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Updated Business Mailing Address July 21, 2009

Registered at 6966 HARVEST RD, BOULDER, CO 803013659 (Tel: 3035301310)

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Provider Name / Credentials Updated July 21, 2009

Recorded as GEORGE WYSHAK, D.M.D

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 21, 2009

Dentist (License #8811 in MA)

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Initial NPI Registration & Enumeration July 21, 2009

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1215167564
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 21, 2009
Last Update: July 21, 2009
Deactivation Date: June 05, 2025

Mailing Address

6966 Harvest Rd

Boulder, CO 803013659

Phone: 3035301310

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.