Kristi Wagner, DDS MS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

60060 Issued in CA

Practice address

2734 Delta Fair Blvd
Antioch, CA 94509-4100

Phone

(925) 778-1234

Fax

(925) 778-3012

NPI assigned

Mar 8, 2007

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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 and National Provider Directory roles.

• Babak Khayatan DDS Inc.

  • General Practice Dentistry
  • Antioch, CA
  • NPI 1639648413
  NPD (past)

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360195200000",
    "number": "1285765362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2734 DELTA FAIR BLVD",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945094100",
            "telephone_number": "925-778-1234",
            "fax_number": "925-778-3012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2734 DELTA FAIR BLVD",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945094100",
            "telephone_number": "925-778-1234",
            "fax_number": "925-778-3012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "KRISTI",
        "name_prefix": "Dr.",
        "credential": "DDS MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2013-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "60060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Von Brauch, PPS
• Tona F. Von Egert
• Rekha Vontela, DDS
• Henry Hai Vu, DDS
• Teresa Vu, PHARMD
• Sara Wais, BCBA
• Walgreen Co
• Lauren Kristine Walian
• Deseray Marie Walker-Perry
• Josephine Walker

• Orthodontics and Dentofacial Orthopedics Dentistry in Antioch, CA
• Providers in Antioch, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2013; 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.