Ann Wagener, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

4529 Issued in WI

Practice address

3030 N Ballard Rd
Appleton, WI 54911-8707

Phone

(920) 954-8085

NPI assigned

Jun 6, 2011

Last updated

Jun 6, 2011By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in WI

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

State licenses

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

{
    "created_epoch": "1307318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307318400000",
    "number": "1962796060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 N BALLARD RD",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549118707",
            "telephone_number": "920-954-8085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 N BALLARD RD",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549118707",
            "telephone_number": "920-954-8085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGENER",
        "first_name": "ANN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-06",
        "last_updated": "2011-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "4529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Micheal Paul Vrabec, M.D.
• Savanna Vue, APSW
• Mark Wade, OD
• Barbara Waedekin, M.D.
• Michael L Wage, MD, PHD
• Christopher W Wagener, MD
• Wagner Family Chiropractic SC
• Wagner Family Chiropractic SC
• Wagner Wellness LLC (Rehab Lab Wisconsin)
• Christopher T Wagner, MD

• Dentist in Appleton, WI
• Providers in Appleton, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2011; 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.