Richard Chisholm Wagner, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DT-1272 Issued in HI

Practice address

1150 S King St Ste 303
Honolulu, HI 96814-1951

Phone

(808) 589-1500

Fax

(808) 589-1220

NPI assigned

Feb 13, 2007

Sex

Male

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1619019676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 S KING ST STE 303",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141951",
            "telephone_number": "808-589-1500",
            "fax_number": "808-589-1220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 S KING ST STE 303",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141951",
            "telephone_number": "808-589-1500",
            "fax_number": "808-589-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "RICHARD",
        "middle_name": "CHISHOLM",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "HI",
            "license": "DT-1272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randall Scott Waddell
• Wade Takenishi D.D.S. L.L.C.
• Darlene Karen Wade, MSW
• Fabienne Marie Wade, PT
• Daniel Tadashi Wagner, DPT
• Tasha N.S.W. Wagner, PHARMD
• Thomas Wahl, MS, ATC, CSCS
• Tricia M. Wahl, PA-C
• Mary A. Wahlman, RPH
• Wai Kahala Dentistry LLC

• General Practice Dentistry in Honolulu, HI
• Providers in Honolulu, HI by specialty
• General Practice Dentistry in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.