Wagner Dental

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

WAGNER DENTAL

Practice address

10699 Freedom St
Garrettsville, OH 44231-1130

Phone

(330) 527-4313

NPI assigned

May 7, 2024

Organization subpart

No

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

Authorized official

Name

Bryan Wagner, DMDNPI 1629621545

Title

Dentist

Phone

(614) 425-5821

Specialties & licenses 1

Addresses

Other names 1

• Garrettsville Dental Group 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.

• Bryan L Wagner, D.M.D.

  • General Practice Dentistry
  • Cleveland, OH
  • NPI 1629621545
  NPD Authorized official

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

{
    "created_epoch": "1715040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715040000000",
    "number": "1386492239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10699 FREEDOM ST",
            "city": "GARRETTSVILLE",
            "state": "OH",
            "postal_code": "442311130",
            "telephone_number": "330-527-4313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10699 FREEDOM ST",
            "city": "GARRETTSVILLE",
            "state": "OH",
            "postal_code": "442311130",
            "telephone_number": "330-527-4313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAGNER DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-07",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "614-425-5821",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Garrettsville Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Timothy a. Andrews Co OD
• Total Lifetime Care Medical Affiliates Inc.
• Carley Ann Truckey
• University Primary Care Practices Inc
• Christine Joyce Hou Vanoss
• Roger Anders Way
• Carrie Wiesenbach
• Kwame A Williams, DPM
• Michelle Witte

• Dental Clinic/Center in Garrettsville, OH
• Providers in Garrettsville, OH by specialty
• Dental Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; 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.