Woodrow Wilson Wagner III, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

145542-9922 Issued in UT

Practice address

754 S Main St
Suite #1
St George, UT 84770-5504

Phone

(435) 674-9777

NPI assigned

Feb 27, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871620641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "754 S MAIN ST",
            "address_2": "SUITE #1",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847705504",
            "telephone_number": "435-674-9777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "754 S MAIN ST",
            "address_2": "SUITE #1",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847705504",
            "telephone_number": "435-674-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "WOODROW",
        "middle_name": "WILSON",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "145542-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Wagner, DMD
• Nicole J Wagner, FNP
• Ward Wallace Wagner, D.C.
• William Wagner, MD
• William J Wagner, MD
• John Wahlen
• Wade Lee Wahlquist, RN, BSN
• Adam Wahlstrom, D.O
• Ceri Wait
• Erin Waite

• General Practice Dentistry in St George, UT
• Providers in St George, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.