DR. PETER LOUIS WAGNER (NPI# 1235676008) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235676008 |
| Entity Type | Individual |
| Full Name | DR. PETER LOUIS WAGNER |
| Credential | DMD |
| Practice Address |
1292 S Market Blvd Chehalis WA 98532-3645 |
| Mailing Address |
705 Crab Orchard Dr Roswell GA 30076 |
| Practice Telephone | 3607486636 |
| Mailing Telephone | 3602696993 |
| Enumeration Date | 2017-01-31 |
| Last Update Date | 2019-09-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | D10580 | OR | Dental Providers |
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
DE60732747 | WA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285995100 | Peter J Wagner | Orthopaedic Surgery | 2 Dudley St Ste 200, Providence, RI 02905 | 2012-06-07 |
| 1245440841 | Peter Wagner | Internal Medicine | 350 Heritage Way, Suite 1100, Kalispell, MT 59901-3158 | 2007-05-23 |
| 1609992932 | Peter C. Wagner | Dentist | 1292 S Market Blvd, Chehalis, WA 98532-3645 | 2007-03-21 |
| 1548356280 | Peter Louis Wagner | Dentist | 10535 N Port Washington Rd, Suite 102, Mequon, WI 53092-5583 | 2006-10-04 |
| 1174531388 | Peter William Wagner | Surgery | 30 W Mccreight Ave, Suite 208, Springfield, OH 45504-1842 | 2006-08-03 |
| 1598734196 | Peter B Wagner | Internal Medicine | 600 Moye Blvd, Greenville, NC 27834-4300 | 2006-03-16 |
| 1659341865 | Peter C Wagner | Family Medicine | 483 W. Seed Farm Rd., Sacaton, AZ 85147-0038 | 2006-01-23 |
| 1396729539 | Peter J Wagner | Internal Medicine | 1221 Whipple St, Eau Claire, WI 54703-5270 | 2005-12-01 |
| 1962403774 | Peter John Wagner | Psychiatry & Neurology | 39700 Bob Hope Dr, Suite 216, Rancho Mirage, CA 92270-3267 | 2005-08-02 |
| Street Address |
1292 S MARKET BLVD |
| City | CHEHALIS |
| State | WA |
| Zip Code | 98532-3645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588773428 | Richard R Walker Dds Ps | Dentist | 1292 S Market Blvd, Chehalis, WA 98532 | 2006-08-30 |
| 1003465964 | Wagner Orthodontics | Dentist | 1292 S Market Blvd, Chehalis, WA 98532-3645 | 2019-09-04 |
| 1609258029 | Ernest Mori Yamane | Dentist | 1292 S Market Blvd, Chehalis, WA 98532-3645 | 2015-06-22 |
| 1568879690 | Daniel Henricksen | Dentist | 1292 S Market Blvd, Chehalis, WA 98532-3645 | 2014-07-21 |
| 1821410663 | Daniel M. Henricksen Dds Ms Pllc | Clinic/Center | 1292 S Market Blvd, Chehalis, WA 98532-3645 | 2014-01-14 |
| 1548407570 | Ernest M. Yamane, Dds Ps | Dentist | 1292 S Market Blvd, Chehalis, WA 98532-3645 | 2009-01-13 |
| 1609992932 | Peter C. Wagner | Dentist | 1292 S Market Blvd, Chehalis, WA 98532-3645 | 2007-03-21 |
| 1629194964 | Peter C. Wagner, D.m.d., P.s. | Dentist | 1292 S Market Blvd, Chehalis, WA 98532-3645 | 2007-03-21 |
| 1235213893 | John Maack Henricksen | Dentist | 1292 S Market Blvd, Chehalis, WA 98532-3645 | 2006-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275140832 | Joshua Russell Wachter | Registered Nurse | 275 W. Vine St., Napavine, WA 98532 | 2020-09-28 |
| 1891339123 | Dara Casey | Technician | 271-1 Romerman Rd, Chehalis, WA 98532 | 2019-10-30 |
| 1265997704 | April D Bacongco | Counselor | 500 Se Washington St, Chehalis, WA 98532 | 2019-02-08 |
| 1235610155 | Alyssa Dawn Ware | Physical Therapist | 1441 Kresky Ave, Chehalis, WA 98532 | 2018-08-28 |
| 1609365238 | American Behavioral Health Systems, Inc. | Substance Abuse Rehabilitation Facility | 500 Se Adams Ave, Chehalis, WA 98532 | 2018-05-09 |
| 1043709314 | Kevin Bumatay Duran | Family Medicine | 931 S. Market Blvd, Chehalis, WA 98532 | 2018-05-02 |
| 1164922324 | William I. Mcmillan | Counselor | 121 Nw Chehalis St., Chehalis, WA 98532 | 2018-02-14 |
| 1285155366 | Great Rivers Behavioral Health Organization | Community/Behavioral Health | 57 W Main Street, Suite 260, Chehalis, WA 98532 | 2017-06-29 |
| 1396273637 | Misty Anne Glenn | Counselor | 121 Nw Chehalis Ave, Chehalis, WA 98532 | 2017-05-31 |
| 1841726221 | Dodi Forgione | Counselor | 2401 Ne Kresky Ave Ste D, Chehalis, WA 98532 | 2017-05-04 |
| Find all providers in zip 98532 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861713760 | Hans Wi Jung | Dentist | 1292 South Market Boulevard, Chehalis, WA 98532 | 2010-06-15 |
| 1003465964 | Wagner Orthodontics | Dentist | 1292 S Market Blvd, Chehalis, WA 98532-3645 | 2019-09-04 |
| 1609992932 | Peter C. Wagner | Dentist | 1292 S Market Blvd, Chehalis, WA 98532-3645 | 2007-03-21 |
| 1629194964 | Peter C. Wagner, D.m.d., P.s. | Dentist | 1292 S Market Blvd, Chehalis, WA 98532-3645 | 2007-03-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114539301 | Jack Hou & Kortne Frederick Hou PC | Dentist | 22603 Ne Inglewood Hill Rd Ste 200, Sammamish, WA 98074-7105 | 2020-08-19 |
| 1629686175 | Paul S. Kahlon, Pllc | Dentist | 13209 44th Ave Se Ste 102, Mill Creek, WA 98012-8985 | 2020-07-21 |
| 1457975948 | Hurst and Shannon Pllc | Dentist | 400 Pine St Ste 2017, Seattle, WA 98101-3625 | 2020-06-01 |
| 1043840200 | Kjeld Aamodt PC | Dentist | 500 108th Ave Ne Ste 1710, Bellevue, WA 98004-5598 | 2020-01-16 |
| 1861040800 | Jack Hou & Kortne Frederick Hou PC | Dentist | 451 Duvall Ave Ne Ste 230, Renton, WA 98059-4675 | 2019-09-03 |
| 1972165942 | Claire Kuo Pllc | Dentist | 4300 Talbot Rd S Ste 401, Renton, WA 98055-6238 | 2019-06-30 |
| 1164089934 | Tri-city Orthodontics, LLC | Dentist | 3200 Duportail St, Ste 203, Richland, WA 99352 | 2019-05-28 |
| 1699331363 | Chet Jenkins PC | Dentist | Pioneer Specialty Services, 110 W Yakima Valley Hwy, Sunnyside, WA 98944-1352 | 2019-05-17 |
| 1578025946 | Samuel Finkleman | Dentist | 411 Strander Blvd Ste 104, Tukwila, WA 98188-2924 | 2019-04-03 |
| 1891250429 | Daniel Lee, Dds, and Christina Lee, Dds, Ms, Pllc | Dentist | 2911 2nd Ave, Suite 106, Seattle, WA 98121-3065 | 2019-02-07 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.