Peter C. Wagner, D.M.D., P.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

6937 Issued in WA

Legal business name

PETER C. WAGNER, D.M.D., P.S.

Practice address

1292 S Market Blvd
Chehalis, WA 98532-3645

Phone

(360) 748-6636

Fax

(360) 748-3176

NPI assigned

Mar 21, 2007

Organization subpart

No

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

Authorized official

Name

Peter C. Wagner, D.M.D., P.S.

Title

President

Phone

(360) 748-6636

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Peter C Wagner DMD PS2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Peter C Wagner DMD PS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Longview, WA
  • NPI 1831320993
  NPD tax ID

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629194964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1292 S MARKET BLVD",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985323645",
            "telephone_number": "360-748-6636",
            "fax_number": "360-748-3176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1292 S MARKET BLVD",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985323645",
            "telephone_number": "360-748-6636",
            "fax_number": "360-748-3176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER C. WAGNER, D.M.D., P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-748-6636",
        "authorized_official_credential": "D.M.D., P.S."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WA",
            "license": "6937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5028469",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Pendleton, LMT
• Andres Perez, MSW
• Carrin Ann Perez, LICSW-A
• Sarah J Perry, LMT
• Personal Hearing Systems, Inc
• Jason R Peterman, R.N.
• Dale Raymond Peters, DC
• Joshua M Petersen, M.ED, LAT, ATC
• John Pham, D.D.S.
• Norma Jane Phillips, LMT

• Orthodontics and Dentofacial Orthopedics Dentistry in Chehalis, WA
• Providers in Chehalis, WA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.