Aniruddha Wagh, DDS

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

5855 E Still Cir
Mesa, AZ 85206-3631

Phone

(408) 248-8107

NPI assigned

Apr 10, 2019

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554854400000",
    "number": "1932662590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 BLUE JAY WAY",
            "city": "REXFORD",
            "state": "NY",
            "postal_code": "121481334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5855 E STILL CIR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063631",
            "telephone_number": "408-248-8107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGH",
        "first_name": "ANIRUDDHA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-10",
        "last_updated": "2019-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Logan Wade
• Richard Earl Wade, FNP-BC
• Rick C Wade, ATC
• Harpreet Singh Wadhwa, MD
• Scott S Wagers
• Amy Lynn Wagner, NMD
• Erik W Wagner, F.N.P.
• Jennifer Wagner, LAMFT
• Joseph E. Wagner, M.D.
• Maralee A Wagner, NP-C

• Student in an Organized Health Care Education/Training Program in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Student in an Organized Health Care Education/Training Program in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2019; 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.