Yen Wagner DDS LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

12010286A Issued in IN

Legal business name

YEN WAGNER DDS LLC

Doing business as

Brighter Image Dental

Practice address

3965 N Meridian St Apt 1C
Indianapolis, IN 46208-4035

Phone

(317) 925-5811

NPI assigned

Jan 12, 2010

Organization subpart

No

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

Authorized official

Name

Yen Wagner, DDSNPI 1285613000

Title

Owner

Phone

(317) 925-5811

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Brighter Image Dental Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Yen T Wagner, DDS

  • Dentist
  • Indianapolis, IN
  • NPI 1285613000
  NPD (past) Authorized official

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

{
    "created_epoch": "1263254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263254400000",
    "number": "1316277411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3965 N MERIDIAN ST APT 1C",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462084035",
            "telephone_number": "317-925-5811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3965 N MERIDIAN ST APT 1C",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462084035",
            "telephone_number": "317-925-5811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YEN WAGNER DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-12",
        "last_updated": "2010-01-12",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "YEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-925-5811",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IN",
            "license": "12010286A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200919550",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brighter Image Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Abideen Olayinka Yekinni, M.D.
• Ramarao Yeleti, MD
• Jana B Yeley, NP
• Jagadeesh Yella, M.D.
• Kayleigh Yelton
• Priya M Yenebere, DO
• Matthew James Yentes, CST
• Hakyung Yeo
• Hayden Yeoman
• Miranda Ovana Yeomans

• Dental Clinic/Center in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Dental Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2010; 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.