Kramer Alexander Pandolfo Wagner, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

60976091 Issued in WA

Practice address

15965 NE 85TH St Ste 201
Redmond, WA 98052-3593

Phone

(425) 885-1873

NPI assigned

Jul 31, 2019

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Kramer a.P. Wagner, DDS, PLLC

  • Dental Clinic/Center
  • Woodinville, WA
  • NPI 1538789730
  NPD Authorized official
• Amar DDS PLLC.

  • Dental Clinic/Center
  • Redmond, WA
  • NPI 1396692356
  NPD (past)

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

{
    "created_epoch": "1564531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1346894987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16602 198TH AVE NE",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "980775417",
            "telephone_number": "206-910-8653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15965 NE 85TH ST STE 201",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523593",
            "telephone_number": "425-885-1873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "KRAMER",
        "middle_name": "ALEXANDER PANDOLFO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-31",
        "last_updated": "2019-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "60976091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CE NUMBER",
            "identifier": "60976091",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jarrod Wadwa, PHARMD
• Lauren Shalane Wagendorf, LMHC, LPCC
• Sharon T Wagener Dewolf, DC
• Rasena Wager
• Shuree Waggoner, LMHC
• Chandra Dawn Wajdik
• Avery Jane Walcher
• Preston Robert Walcker
• Halli Broder Waldbaum, PHARM.D.
• Walgreen Co

• General Practice Dentistry in Redmond, WA
• Providers in Redmond, 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 31, 2019; 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.