DR. RICHARD M WAGNER


Address: 1925 South Green Bay Rd, Racine, WI 53406-4654
Phone: 2626344646

DR. RICHARD M WAGNER (NPI# 1770700957) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1770700957
Entity Type Individual
Full Name DR. RICHARD M WAGNER
Credential DDS
Practice Address 1925 South Green Bay Rd
Racine
WI 53406-4654
Practice Telephone 2626344646
Practice Fax Number 2626344694
Mailing Telephone 2626344646
Mailing Fax Number 2626344694
Enumeration Date 2007-04-19
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223S0112X Dentist
Specialization: Oral and Maxillofacial Surgery
3092 WI Dental Providers

Other Provider Identifier

State Issuer Identifier Type Code
WI 33491300 05

Other Providers RICHARD WAGNER

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Office Location

Street Address 1925 SOUTH GREEN BAY RD
City RACINE
State WI
Zip Code 53406-4654

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1578164349 Lynn Huynh Pharmacist 5695 Washington Ave, Racine, WI 53406 2020-11-06
1659920049 Carol Jean Cornejo Technician 6528 Heritage Avenue, Mt Pleasant, WI 53406 2019-09-09
1265913958 Mary Goldbeck Social Worker 1775 Newman Rd, Mt Pleasant, WI 53406 2018-08-22
1669963344 Kelly Nicole Nelson Registered Nurse 8800 Washington Ave Ste 200, Mount Pleasant, WI 53406 2018-05-29
1891212163 Ilona Agata Pryomski Nurse Practitioner 9201 Washington Ave, Racine, WI 53406 2017-08-27
1386185106 Margaret M. Abaogye Dds Dentist 4340 Newman Rd., Racine, WI 53406 2017-03-13
1508309212 Rebecca Koeppen Dietitian, Registered 8400 Washington Ave., Racine, WI 53406 2016-11-29
1386194371 Forefront Dermatology, S.c. Dermatology 7200 Washington Ave, Suite 100, Mount Pleasant, WI 53406 2016-10-13
1356891402 Forefront Dermatology, S.c. Dermatology 1515 S Green Bay Rd, Racine, WI 53406 2016-10-12
1861841470 Leah Marie Johnson Dentist 1101 South Airline Road, Racine, WI 53406 2016-06-06
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Taxonomy Information

Taxonomy Code 1223S0112X
Grouping Dental Providers
Classification Dentist
Specialization Oral and Maxillofacial Surgery

Taxonomy Definition

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

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1437218302 Donald Edward Romsa Dentist 5801 Washington Avenue, Suite 102, Racine, WI 53406 2006-12-07
1831275312 Don Louis Selmo Dentist 1320 S Greenbay Rd, Racine, WI 53406-4406 2006-10-27

Providers in the same taxonomy and state

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
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Competitor

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City RACINE
Zip Code 53406

Improve Information

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Dataset Information

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.

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