DR. PETER LOUIS WAGNER (NPI# 1548356280) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548356280 |
| Entity Type | Individual |
| Full Name | DR. PETER LOUIS WAGNER |
| Credential | D.D.S. |
| Practice Address |
10535 N Port Washington Rd Suite 102 Mequon WI 53092-5583 |
| Practice Telephone | 2622410900 |
| Practice Fax Number | 2622410904 |
| Mailing Telephone | 2622410900 |
| Mailing Fax Number | 2622410904 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2008-07-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
5604-015 | WI | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235676008 | Peter Louis Wagner | Dentist | 1292 S Market Blvd, Chehalis, WA 98532-3645 | 2017-01-31 |
| 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 |
| 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 |
10535 N PORT WASHINGTON RD SUITE 102 |
| City | MEQUON |
| State | WI |
| Zip Code | 53092-5583 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336233790 | Mark J Kortebein | Dentist | 10535 N Port Washington Rd, Suite 102, Mequon, WI 53092-5583 | 2006-10-02 |
| 1306089636 | Danielle Andrea Lindberg | Counselor | 10535 N Port Washington Rd, Suite 1b, Mequon, WI 53092-5583 | 2009-04-16 |
| 1336287895 | Craig Renold Carr | Dentist | 10535 N Port Washington Rd, Mequon, WI 53092-5583 | 2007-02-04 |
| 1477647832 | Oral Surgery Associates of Milwaukee Sc | Dentist | 10535 N Port Washington Rd, Suite 102, Mequon, WI 53092-5583 | 2006-10-02 |
| 1760576128 | Alan A Kimmel | Dentist | 10535 N Port Washington Rd, Suite 102, Mequon, WI 53092-5583 | 2006-10-02 |
| 1962596395 | Sheppard B Mollick | Dentist | 10535 N Port Washington Rd, Suite 102, Mequon, WI 53092-5583 | 2006-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942790761 | Kathryn Mueller | Specialist/Technologist | 117 Linden Lane, Apt 7, Thiensville, WI 53092 | 2018-05-17 |
| 1427547082 | Shopko Stores Operating Co LLC | Eyewear Supplier (Equipment, not the service) | 10996 N Port Washington Rd, Mequon, WI 53092 | 2018-05-08 |
| 1912437252 | Froedtert & The Medical College of Wisconsin Community Physicians Inc | Durable Medical Equipment & Medical Supplies | 11430 Port Washington Road, Mequon, WI 53092 | 2017-06-19 |
| 1629437256 | Sean S Tsang | Acupuncturist | 909 W. Mequon Rd., Mequon, WI 53092 | 2016-02-10 |
| 1497128433 | Nancy Snoots | Counselor | 4430 W Tarrytown Ln, Mequon, WI 53092 | 2015-11-12 |
| 1609265214 | Evan Guettel | Physical Therapist | 11363 N. Port Washington Road, Mequon, WI 53092 | 2015-01-20 |
| 1881091148 | Sarah Krueger | Counselor | 216 N Green Bay Rd Suite 108, Thiensville, WI 53092 | 2014-12-01 |
| 1245667088 | Lora Transportation, LLC | Non-emergency Medical Transport (VAN) | 1228 West Baldwin Crt., Mequon, WI 53092 | 2013-10-10 |
| 1710314000 | Roxxi M Davis | Social Worker | 7113 Tamarack Ct, Mequon, WI 53092 | 2013-10-01 |
| 1225473713 | Forefront Dermatology, S.c. | Dermatology | 10303 N Port Washington Rd Ste 101, Mequon, WI 53092 | 2013-05-09 |
| Find all providers in zip 53092 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336233790 | Mark J Kortebein | Dentist | 10535 N Port Washington Rd, Suite 102, Mequon, WI 53092-5583 | 2006-10-02 |
| 1306837794 | Adam Christopher Miller | Dentist | 10602 N Port Washington Rd, Ste. 101, Mequon, WI 53092-5079 | 2005-11-03 |
| 1306908371 | Brent J Martin Dds Ms Sc | Dentist | 1345 W Towne Square Rd, Mequon, WI 53092-5047 | 2006-12-15 |
| 1477647832 | Oral Surgery Associates of Milwaukee Sc | Dentist | 10535 N Port Washington Rd, Suite 102, Mequon, WI 53092-5583 | 2006-10-02 |
| 1760576128 | Alan A Kimmel | Dentist | 10535 N Port Washington Rd, Suite 102, Mequon, WI 53092-5583 | 2006-10-02 |
| 1962596395 | Sheppard B Mollick | Dentist | 10535 N Port Washington Rd, Suite 102, Mequon, WI 53092-5583 | 2006-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720569783 | Greater Milwaukee Oral Surgery, L.L.C. | Dentist | 4811 S 76th St Ste 304, Greenfield, WI 53220-4350 | 2018-08-27 |
| 1124516893 | Baycare Clinic, LLP | Dentist | 636 N 12th Ave, Sturgeon Bay, WI 54235-1249 | 2018-04-27 |
| 1477065787 | Central Wisconsin Oral and Facial Surgery, LLC | Dentist | 438 Edison St, Antigo, WI 54409-1845 | 2017-10-26 |
| 1497266910 | Donald Ervin Linneman | Dentist | Center 4820 N Sherman Road, Winnebago Correction Center, Drug Abuse Correctional, Winnebago, WI 54985-0036 | 2017-10-24 |
| 1063869485 | Tyler Kalmuck | Dentist | 3637 Wilgus Ave, Sheboygan, WI 53081-3050 | 2016-05-16 |
| 1952717753 | Judson Charles Smith | Dentist | 2323 N Mayfair Rd Ste 102, Milwaukee, WI 53226 | 2014-07-01 |
| 1073930459 | Paul Pamula | Dentist | 1925 S Green Bay Rd, Mount Pleasant, WI 53406-4654 | 2014-03-24 |
| 1326473927 | Lake Geneva Dental Care, LLC | Dentist | 1454 E Huebbe Pkwy, Beloit, WI 53511-1714 | 2013-09-13 |
| 1093154601 | Matthew D Reiland | Dentist | 2921 Landmark Pl Ste 100, Madison, WI 53713-4248 | 2013-06-17 |
| 1922364363 | Ell Louis Lee | Dentist | 2361 Lost Dauphin Rd, De Pere, WI 54115-9165 | 2012-04-10 |
| 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.