NPIMap

Organization Active NPI

Robert H Wagner Family Dentist S.C.

  • General Practice Dentistry
  • Green Bay, WI
National Provider Identifier
1124670898
Registry record updated Jul 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ROBERT H WAGNER FAMILY DENTIST S.C.
Practice address
2830 Curry Court
Suite 1
Green Bay, WI 54311
Phone
(920) 432-7230
Fax
(920) 432-6948
NPI assigned
Jul 12, 2019
Last updated
Jul 12, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2019

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

Authorized official

Name
Dr. Robert Harold Wagner, DDSNPI 1780638585
Title
Dentist/Owner
Phone
(920) 432-7230

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

2830 Curry Court
Suite 1
Green Bay, WI 54311

Mailing address

2830 Curry Court
Suite 1
Green Bay, WI 54311
Phone (920) 432-7230

National Provider Directory

National Provider Directory

Locations

2830 Curry Ct
Ste 1
Green Bay, WI 54311
Phone (920) 432-7230

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1562889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562889600000",
    "number": "1124670898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2830 CURRY COURT",
            "address_2": "SUITE 1",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54311",
            "telephone_number": "920-432-7230",
            "fax_number": "920-432-6948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2830 CURRY COURT",
            "address_2": "SUITE 1",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54311",
            "telephone_number": "920-432-7230",
            "fax_number": "920-432-6948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT H WAGNER FAMILY DENTIST S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-12",
        "last_updated": "2019-07-12",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "HAROLD",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "920-432-7230",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2019; 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.