Active NPI
Christopher Wagner
- General Practice Dentistry
- Seattle, WA
National Provider Identifier
1023562907
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 60675722
- Practice address
- 4700 42ND Ave SW
Suite 460
Seattle, WA 98116-4591 - Phone
- (206) 767-4851
- NPI assigned
- Aug 9, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 60675722 | WA | Primary |
Addresses
Primary practice location
4700 42ND Ave SW
Suite 460
Seattle, WA 98116-4591
Mailing address
4808 37TH Ave NE
Seattle, WA 98105-3017
Phone (360) 624-3235
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60675722 | WA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470700800000",
"number": "1023562907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4808 37TH AVE NE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981053017",
"telephone_number": "360-624-3235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4700 42ND AVE SW",
"address_2": "SUITE 460",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981164591",
"telephone_number": "206-767-4851"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "CHRISTOPHER",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-08-09",
"last_updated": "2016-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WA",
"license": "60675722",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.