NPIMap

Organization Active NPI

Waggoner & Associates PC

  • Pediatric Dentistry
  • Las Vegas, NV
National Provider Identifier
1740684430
Registry record updated Oct 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
S6-17 Issued in NV
Legal business name
WAGGONER & ASSOCIATES PC
Doing business as
Kids' Dental Safari
Practice address
2381B Renaissance Dr
Las Vegas, NV 89119-6498
Phone
(702) 373-9526
NPI assigned
Oct 9, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2014

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

Authorized official

Name
Dr. William Waggoner, DDS, MS
Title
President
Phone
(702) 254-4220

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X S6-17 NV Primary

Addresses

Primary practice location

2381B Renaissance Dr
Las Vegas, NV 89119-6498

Mailing address

8981 W Sahara Ave
Suite 110
Las Vegas, NV 89117-5897
Phone (702) 254-4220

Other names 1

  • Kids' Dental Safari Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kids' Dental Safari2 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.

NPI Registry JSON

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

{
    "created_epoch": "1412812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412812800000",
    "number": "1740684430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8981 W SAHARA AVE",
            "address_2": "SUITE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891175897",
            "telephone_number": "702-254-4220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2381B RENAISSANCE DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891196498",
            "telephone_number": "702-373-9526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAGGONER & ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-09",
        "last_updated": "2014-10-09",
        "status": "A",
        "authorized_official_last_name": "WAGGONER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-254-4220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NV",
            "license": "S6-17",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kids' Dental Safari",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2014; 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.