Carson B Wagstaff, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

D-4299 Issued in ID

Practice address

13435 N Lon Adams Rd
Marana, AZ 85653

Phone

(520) 989-0270

NPI assigned

Jul 6, 2010

Last updated

Dec 11, 2013By 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

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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.

• Carson B. Wagstaff, DMD, PLC

  • Dental Clinic/Center
  • Marana, AZ
  • NPI 1932530151
  NPD (past) Authorized official

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

{
    "created_epoch": "1278374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386720000000",
    "number": "1255643359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 W MOODIE DR",
            "city": "ORO VALLEY",
            "state": "AZ",
            "postal_code": "857556000",
            "telephone_number": "801-979-2035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13435 N LON ADAMS RD",
            "city": "MARANA",
            "state": "AZ",
            "postal_code": "85653",
            "telephone_number": "520-989-0270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGSTAFF",
        "first_name": "CARSON",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-06",
        "last_updated": "2013-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "D-4299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann Marie Unrast, LPCC
• Miranda Valenzuela
• Stephen Edward Vanourny, M.D.
• Megan Gerene Vettorel, FNP-C
• Janice Vicente, DNP, PMHNP-C
• Walgreen Co (Walgreens #09952)
• Barbara J Webb, ED.D.
• Melissa Curtis Webb, LPC
• Karen Weber, DO
• Alyssa Weller, NP

• Dentist in Marana, AZ
• Providers in Marana, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.