Will Wagner D.M.D., LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5177 Issued in AL

Legal business name

WILL WAGNER D.M.D., LLC

Practice address

1663 McFarland Blvd N
Suite G-5
Tuscaloosa, AL 35406-2250

Phone

(205) 349-9092

NPI assigned

Oct 4, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Will Wagner, D.M.D.

Title

Member

Phone

(205) 349-9092

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1349308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349308800000",
    "number": "1316299076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 HARTFORD DR",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354061799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1663 MCFARLAND BLVD N",
            "address_2": "SUITE G-5",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062250",
            "telephone_number": "205-349-9092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILL WAGNER D.M.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-04",
        "last_updated": "2012-10-04",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "WILL",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "205-349-9092",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "5177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valerie U Wiggins, APRN,BC
• Sondra Wilder, CRNP
• James Brian Wilhite, M.D.
• Trevia D Wilkerson
• Gavin Ray Wilks, M.D.
• Ellen Catherine Willett, PT, DPT
• Williams Eye Center LLC
• Ashley Jenise Williams, ALC,NCC
• Brittney Williams, LICSW
• Brodrick Marquis Williams Jr., MA, LPC

• General Practice Dentistry in Tuscaloosa, AL
• Providers in Tuscaloosa, AL by specialty
• General Practice Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2012; 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.