Wagner Dental LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

WAGNER DENTAL LLC

Practice address

2045 Village Center Cir
Las Vegas, NV 89134-6251

Phone

(702) 878-5599

Fax

(702) 878-0173

NPI assigned

Sep 2, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ronald Kent Wagner Jr., DDS

Title

Manager

Phone

(702) 878-5599

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1409616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409616000000",
    "number": "1003216698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2045 VILLAGE CENTER CIR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891346251",
            "telephone_number": "702-878-5599",
            "fax_number": "702-878-0173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 VILLAGE CENTER CIR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891346251",
            "telephone_number": "702-878-5599",
            "fax_number": "702-878-0173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAGNER DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-02",
        "last_updated": "2014-09-02",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "KENT",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "702-878-5599",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Waggoner and Associates, PC
• Waggoner Professional Services PC
• Elizabeth Adrienne Waggoner, M.S., MFT INTERN
• Jayme Waggoner
• William F. Waggoner, D.D.S., M.S.
• Lauren Elyse Wagner-Powell, LCSW
• Arminas Stasys Wagner, D.C.
• Barbara Ann Wagner
• Brittany Wagner
• Brooke Wagner

• Dentist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Dentist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2014; 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.