DR. MARK ALBERT WAGGONNER (NPI# 1578541355) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578541355 |
| Entity Type | Individual |
| Full Name | DR. MARK ALBERT WAGGONNER |
| Credential | DDS |
| Practice Address |
28401 Bradley Rd Sun City CA 92586-3040 |
| Mailing Address |
12020 Paradise St Grand Terrace CA 92313-5335 |
| Practice Telephone | 9516796355 |
| Practice Fax Number | 9516796355 |
| Mailing Telephone | 9098246251 |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
24189 | CA | Dental Providers |
| Street Address |
28401 BRADLEY RD |
| City | SUN CITY |
| State | CA |
| Zip Code | 92586-3040 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750817961 | Zareh Family Dental Inc. | Dentist | 28401 Bradley Rd, Suite B, Sun City, CA 92586-3040 | 2017-05-08 |
| 1245512649 | Reza M. Birjandi Dds., A Professional Dental Corporation | Dentist | 28401 Bradley Rd, Suite C, Sun City, CA 92586-3040 | 2011-09-13 |
| 1154479699 | Glenn A. Martin | Dentist | 28401 Bradley Rd, Suite D, Sun City, CA 92586-3040 | 2007-01-08 |
| 1619068137 | Evelyn Na-adjieley Tetteh-martey | Internal Medicine | 28401 Bradley Rd, #a, Sun City, CA 92586 | 2006-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053586800 | Binoy Govindbhai Patel | Physical Therapist | 29798 Haun Rd Ste 201, Menifee, CA 92586 | 2008-04-23 |
| 1164552667 | Diana Suzanne Koenen | Marriage & Family Therapist | Sun Plaza Business Center, 27851 Bradley Rd, Suite 103, Menifee, CA 92586 | 2007-03-06 |
| 1972654804 | Mike Johnson | Specialist | 26916 Cherry Hills Boulevard, Sun City, CA 92586 | 2007-01-16 |
| 1932256849 | Mandana Mirshahzadeh | Nurse Practitioner | 26926 Cherry Hills Blvd Ste B, Menifee, CA 92586 | 2007-01-04 |
| 1184709248 | Technomed Homecare Inc | Durable Medical Equipment & Medical Supplies | 27188 Sun City Blvd, Sun City, CA 92586 | 2006-10-26 |
| 1922193754 | Minh Pham | Dentist | 29950 Haun Rd, Ste 302, Sun City, CA 92586 | 2006-10-04 |
| 1598739203 | Kevin Khuong Nguyen | Family Medicine | 29798 Haun Road, Suite 203, Menifee, CA 92586 | 2006-02-17 |
| 1831199728 | Duane Ray Darnell | Internal Medicine | 27994 Bradley Rd, Ste F, Sun City, CA 92586 | 2005-07-21 |
| 1417445040 | Blair N Kluth | Behavioral Analyst | 27070 Sun City Blvd, Menifee, CA 92586 | 2018-04-30 |
| 1043723869 | New Hope Rx Pharmacy, Inc | Pharmacy | 29798 Haun Rd Ste 100, Menifee, CA 92586 | 2017-11-15 |
| Find all providers in zip 92586 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568024834 | Hdp Mccaffrey Dental LLC | Dentist | 10147 Grand Ave Ste A-5, Sun City, AZ 85351-3435 | 2019-07-08 |
| 1326609843 | Hdp Fox Dental LLC | Dentist | 10147 Grand Ave Ste A-3, Sun City, AZ 85351-3435 | 2019-06-25 |
| 1922663673 | Hdp Sunridge Dental LLC | Dentist | 13830 W Camino Del Sol Ste 200, Sun City, AZ 85375-4746 | 2019-05-08 |
| 1467956730 | Jerry M. Burns Dds PC II | Dentist | 13404 N Del Webb Blvd, Sun City, AZ 85351-2750 | 2018-03-21 |
| 1578743753 | Ddl Dental | Dentist | 15416 N 99th Ave, Sun City, AZ 85351-1962 | 2007-11-06 |
| 1235346602 | Min Kyung Ku | Dentist | 29950 Haun Rd Ste 302, Sun City, CA 92586-6527 | 2007-05-16 |
| 1386858702 | Clara Patricia Fajardo | Dentist | 18818 N 99th Ave, Sun City, AZ 85373-1431 | 2007-05-09 |
| 1265655229 | Thavisab Noy Hatlavongsa | Dentist | 29798 Haun Rd Ste 306, Sun City, CA 92586-6542 | 2007-04-10 |
| 1205955903 | Martin J. Margetis | Dentist | 13624 N 99th Ave, Sun City, AZ 85351-2813 | 2007-03-27 |
| 1003957457 | H. Pourshirazi Dmd, Inc | Dentist | 27851 Bradley Rd Ste 155, Sun City, CA 92586-2244 | 2007-02-09 |
| Find all providers in SUN CITY | ||||
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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.