Carol L Wacker

Primary specialty

DentistTaxonomy code 122300000X

License

009860 Issued in CT

Practice address

982 E Main St
Bridgeport, CT 06608-1913

Phone

(203) 696-3270

Fax

(203) 332-0376

NPI assigned

Aug 28, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1219881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219881600000",
    "number": "1932357332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "471 BARNUM AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066082409",
            "telephone_number": "203-333-6864",
            "fax_number": "203-332-0376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "982 E MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066081913",
            "telephone_number": "203-696-3270",
            "fax_number": "203-332-0376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WACKER",
        "first_name": "CAROL",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-28",
        "last_updated": "2008-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "009860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "009860",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Josephina Anna Vossen, M.D.
• Marigot Vreeland, D.C.
• Rosemary Vu, PA-C
• Alex Lea Vuolo, PA-C
• W.a.D.E Care
• Dana Paris Wade, MD
• Katherine M Wagner-Reiss, M.D.
• Amanda Wagner, APRN, CRNA
• Anja Wagner, MD
• Michael Geoffrey Wagner, DO

• Dentist in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Dentist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.