Michael J. Wagner

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

602680925 Issued in WA

Legal business name

MICHAEL J. WAGNER

Practice address

13515 NE 175TH St
Suite G
Woodinville, WA 98072-8566

Phone

(425) 483-2600

Fax

(425) 483-0840

NPI assigned

Jul 19, 2016

Last updated

Jul 19, 2016By 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

Dr. Michael John Wagner, DMD, PSNPI 1609903178

Title

Owner/ Orthodontist

Phone

(425) 483-2600

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, and the practitioner matching its NPPES authorized official.

• Michael John Wagner, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Woodinville, WA
  • NPI 1609903178
  Authorized official Same address or phone

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

{
    "created_epoch": "1468886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468886400000",
    "number": "1851744478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13515 NE 175TH ST",
            "address_2": "SUITE G",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "980728566",
            "telephone_number": "425-483-2600",
            "fax_number": "425-483-0840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13515 NE 175TH ST",
            "address_2": "SUITE G",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "980728566",
            "telephone_number": "425-483-2600",
            "fax_number": "425-483-0840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL J. WAGNER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-19",
        "last_updated": "2016-07-19",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER/ ORTHODONTIST",
        "authorized_official_telephone_number": "425-483-2600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, PS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WA",
            "license": "602680925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Josephine Tenney Meisch, LMP
• Amy Marie Melick, PHD
• Linda L. Meredith, P.T.
• Shannon Michelle Mertens, PHARMD, RPH
• Estela Meza, LMP
• Michael Koczarski DDS GPS PLLC (Koczarski Family & Aesthetic Dentistry)
• Cecile Culp Mielenz, PH.D.
• Erin Christine Milhem, PSY.D.
• Jill Truex Miller, MD
• Rebecca Marie Miller, DPT

• Orthodontics and Dentofacial Orthopedics Dentistry in Woodinville, WA
• Providers in Woodinville, 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 Jul 19, 2016; 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.