Lloyd William Wagner III, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

5177 Issued in AL

Practice address

217 McFarland Circle North
Tuscaloosa, AL 35406

Phone

(205) 345-7755

Fax

(205) 343-9075

NPI assigned

Oct 17, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dental Associates of Tuscaloosa LLC

  • Dentist
  • Tuscaloosa, AL
  • NPI 1942394820
  NPD (past)
• Vandervoort Family Dentistry, PC

  • General Practice Dentistry
  • Tuscaloosa, AL
  • NPI 1841785052
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083794549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 MCFARLAND CIRCLE NORTH",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "35406",
            "telephone_number": "205-345-7755",
            "fax_number": "205-343-9075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 MCFARLAND CIRCLE NORTH",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "35406",
            "telephone_number": "205-345-7755",
            "fax_number": "205-343-9075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "LLOYD",
        "middle_name": "WILLIAM",
        "name_suffix": "III",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "5177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51526480",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vital in-Home Care, LP (Vital In Home Care)
• Vital Span Care LLC
• Vincent Angelo Santiago Volante, MD
• Jennifer Rose Voyles, PHARMD
• Aaron Thomas Wade, MSW
• Samuel Jacob Waits Jr., M.D.
• Wal-Mart Stores East LP (Walmart Pharmacy 10-5256)
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-0715)
• Wal-Mart Stores East, LP (Walmart Pharmacy 10-2500)
• Wal-Mart Stores East, LP (Vision Center 30-0715)

• Dentist in Tuscaloosa, AL
• Providers in Tuscaloosa, AL by specialty
• Dentist in Alabama

• 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.