Alexis Dawn Wagoner, DA

Primary specialty

Dental AssistantTaxonomy code 126800000X

Practice address

3902 Cottonwood St
Longview, WA 98632-4911

Phone

(360) 425-7753

NPI assigned

Oct 5, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083700231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3902 COTTONWOOD ST",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986324911",
            "telephone_number": "360-425-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3902 COTTONWOOD ST",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986324911",
            "telephone_number": "360-425-7753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGONER",
        "first_name": "ALEXIS",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "DA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Vogle, DO
• Juniper W Vojta, PMHNP
• Taylor Voth, AAC
• W. Kalob Lesh DDS PLLC
• Chad Wade, DDS
• Hope K Wagoner, AAC, CPC
• Wal-Mart Stores, Inc
• Gina Lynn Wald, CRNA
• Walgreen Co
• Cristina Y Walker

• Dental Assistant in Longview, WA
• Providers in Longview, WA by specialty
• Dental Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.