Scott Wagnild DDS,LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SCOTT WAGNILD DDS,LLC

Practice address

1108 Western Ave
Fergus Falls, MN 56537-4808

Phone

(218) 736-4000

Fax

(218) 736-0766

NPI assigned

Sep 3, 2020

Organization subpart

No

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

Authorized official

Name

Charlene Klovstad

Title

Business Manager

Phone

(218) 736-4000

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Scott Allan Wagnild, DDS

  • Dentist
  • Fergus Falls, MN
  • NPI 1578682035
  NPD

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

{
    "created_epoch": "1599091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1033723309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 WESTERN AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565374808",
            "telephone_number": "218-736-4000",
            "fax_number": "218-736-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 WESTERN AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565374808",
            "telephone_number": "218-736-4000",
            "fax_number": "218-736-0766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "124 E Lincoln Ave",
            "address_purpose": "LOCATION",
            "city": "Fergus Falls",
            "state": "MN",
            "postal_code": "565372217",
            "country_code": "US",
            "telephone_number": "218-736-5627",
            "fax_number": "218-736-0766",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SCOTT WAGNILD DDS,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-03",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-03",
        "status": "A",
        "authorized_official_last_name": "KLOVSTAD",
        "authorized_official_first_name": "CHARLENE",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "218-736-4000"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "northernlakesdental@prtel.com",
            "affiliation": "Y",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1108 Western Ave",
            "city": "Fergus Falls",
            "state": "MN",
            "country_code": "US",
            "postal_code": "565374808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Becky Bea Schultz, LPN
• Cheryl Ann Schultz, NP
• Erika Schwartz, RN
• Ashley Schwarz
• Becky Schwarzhoff, LADC, LSW
• Deann M Seedorf
• Amy Seidel
• Baylee Seiferlein, NP
• Jaime Christine Sem, LPN
• Servant Residential Care Incorporated

• Dental Clinic/Center in Fergus Falls, MN
• Providers in Fergus Falls, MN by specialty
• Dental Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.