David Wagner, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6755 Issued in WA

Practice address

1919 N Pearl St Ste A3
Tacoma, WA 98406-2456

Phone

(253) 761-5299

Fax

(253) 761-1058

NPI assigned

Oct 17, 2006

Sex

Male

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

State licenses

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": "1205917523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 N PEARL ST STE A3",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984062456",
            "telephone_number": "253-761-5299",
            "fax_number": "253-761-1058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 N PEARL ST STE A3",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984062456",
            "telephone_number": "253-761-5299",
            "fax_number": "253-761-1058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "6755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn Rachelle Wadleigh, LM, CPM
• Troy W Wadsworth, M.D.
• Sabina A Wagner-Lewis, MSW
• Amanda Diane Wagner, R.D.
• Danaka Wagner
• Erik Joseph Wagner, OTR/L
• Kelsey Ruth Wagner
• Marie Wagner
• Stephen Anthony Wagner
• Vitas Erik Wagner, MD

• General Practice Dentistry in Tacoma, WA
• Providers in Tacoma, WA by specialty
• General Practice Dentistry 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.