Active NPI
Dawn Marie Wagner, DMD, FAGD
- Orthodontics and Dentofacial Orthopedics Dentistry
- Tinker Afb, OK
National Provider Identifier
1699754028
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- DS029369L
- Practice address
- 7050 Air Depot Blvd
Tinker Afb, OK 73145-8716 - Phone
- (405) 582-6400
- NPI assigned
- Jan 13, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | DS029369L | PA | Primary |
Addresses
Primary practice location
7050 Air Depot Blvd
Tinker Afb, OK 73145-8716
Mailing address
7050 Air Depot Blvd
Tinker Afb, OK 73145-8716
Phone (405) 582-6400
Other practice location 1
86th Medical Group Bldg 301
Dental Clinic
Apo, AE 09094
Phone 06371462113
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS029369L | PA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571788800000",
"number": "1699754028",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7050 AIR DEPOT BLVD",
"city": "TINKER AFB",
"state": "OK",
"postal_code": "731458716",
"telephone_number": "405-582-6400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7050 AIR DEPOT BLVD",
"city": "TINKER AFB",
"state": "OK",
"postal_code": "731458716",
"telephone_number": "405-582-6400"
}
],
"practiceLocations": [
{
"address_1": "86th Medical Group Bldg 301",
"address_2": "Dental Clinic",
"address_purpose": "LOCATION",
"city": "APO",
"state": "AE",
"postal_code": "09094",
"country_code": "US",
"telephone_number": "06371462113",
"country_name": "United States",
"address_type": "MIL"
}
],
"basic": {
"last_name": "WAGNER",
"first_name": "DAWN",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "DMD, FAGD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-13",
"last_updated": "2019-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "PA",
"license": "DS029369L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tinker Afb, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.