Rudolph M. Wagner, DMD, PLLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

RUDOLPH M. WAGNER, DMD, PLLC

Practice address

2595 Tampa Rd Ste I
Palm Harbor, FL 34684-3131

Phone

(727) 785-8847

NPI assigned

Jul 20, 2021

Organization subpart

No

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

Authorized official

Name

Rudolph Wagner, DMDNPI 1154556132

Title

Orthodontist/ Managing Member

Phone

(727) 785-8847

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rudolph Michael Wagner, D.M.D.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Palm Harbor, FL
  • NPI 1154556132
  NPD Authorized official

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

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626739200000",
    "number": "1679146435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2595 TAMPA RD STE I",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346843131",
            "telephone_number": "727-785-8847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2595 TAMPA RD STE I",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346843131",
            "telephone_number": "727-785-8847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUDOLPH M. WAGNER, DMD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-20",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "RUDOLPH",
        "authorized_official_title_or_position": "ORTHODONTIST/ MANAGING MEMBER",
        "authorized_official_telephone_number": "727-785-8847",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jay Howard Ross, M.D.
• David S Rothberg, M.D.
• Darren Martin Rothschild, M.D.
• Deborah S Rouchon, CRNA
• Stephen Francis Rubano, PHARMACIST
• Karina Ruiz
• Krystal A Rusch, MSW, LCSW
• James Andrew Rush, MEDICAL DOCTOR
• Les D. Ruskin, D.C.
• Tara M Rusoff, O.D.

• Orthodontics and Dentofacial Orthopedics Dentistry in Palm Harbor, FL
• Providers in Palm Harbor, FL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; 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.