Wagoner Family Dentistry, PC

Primary specialty

DentistTaxonomy code 122300000X

License

5069 Issued in OK

Legal business name

WAGONER FAMILY DENTISTRY, PC

Practice address

900 E Cherokee St
Wagoner, OK 74467-4718

Phone

(918) 485-2200

Fax

(918) 485-8877

NPI assigned

Feb 1, 2008

Last updated

Feb 1, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael K Craig, D.D.S.NPI 1871613596

Title

Owner

Phone

(918) 485-2200

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Kale Craig, DDS

  • General Practice Dentistry
  • Wagoner, OK
  • NPI 1871613596
  NPD (past) Authorized official

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

{
    "created_epoch": "1201824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201824000000",
    "number": "1821276817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 E CHEROKEE ST",
            "city": "WAGONER",
            "state": "OK",
            "postal_code": "744674718",
            "telephone_number": "918-485-2200",
            "fax_number": "918-485-8877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E CHEROKEE ST",
            "city": "WAGONER",
            "state": "OK",
            "postal_code": "744674718",
            "telephone_number": "918-485-2200",
            "fax_number": "918-485-8877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAGONER FAMILY DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-01",
        "last_updated": "2008-02-01",
        "status": "A",
        "authorized_official_last_name": "CRAIG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-485-2200",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "5069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristy Lea Vowell, RPH, PHARM.D.
• Wagoner Care Center LLC
• Wagoner Care Center LLC (Wagoner Care Center)
• Wagoner Eye Clinic Inc
• Wagoner Family Dental, PLLC
• Wagoner Health & Rehab LLC (Wagoner Health & Rehab)
• Wagoner Hospital Authority
• Wagoner Hospital Authority
• Wagoner Hospital Authority (Wagoner Hospital Authority dba Wagoner Community Hospital)
• Wagoner Orthopedic Center

• Dentist in Wagoner, OK
• Providers in Wagoner, OK by specialty
• Dentist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2008; 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.