SPENCER B WAGNER DMD PC (NPI# 1205897378) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205897378 |
| Entity Type | Organization |
| Organization Name | SPENCER B WAGNER DMD PC |
| Practice Address |
1987 Allendale Fairfax Hwy Fairfax SC 29827-9137 |
| Mailing Address |
Po Box 830 Fairfax SC 29827-0830 |
| Practice Telephone | 8036323301 |
| Practice Fax Number | 8036321240 |
| Mailing Telephone | 8036323301 |
| Mailing Fax Number | 8036321240 |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2008-10-07 |
| Authorized Official Name | SPENCER B WAGNER (DENTIST) |
| Authorized Official Telephone | 8036323301 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
3192 | SC | Ambulatory Health Care Facilities |
| Street Address |
1987 ALLENDALE FAIRFAX HWY |
| City | FAIRFAX |
| State | SC |
| Zip Code | 29827-9137 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467843078 | We Care Family Resource LLC | Point of Service | 513 Bayshore Dr., Fairfax, SC 29827 | 2015-02-18 |
| 1154606440 | Robert M. Haberkorn Dds | Clinic/Center | 1987 Allendale Fairfax Hwy., Fairfax, SC 29827 | 2011-10-18 |
| 1144370503 | Allendale County Hospital Board | Clinic/Center | 1787 Allendale Fairfax Highway, Fairfax, SC 29827 | 2007-01-10 |
| 1336246677 | Allendale County Hospital Board | Skilled Nursing Facility | 185 Revolutionary Trail, Fairfax, SC 29827 | 2006-09-20 |
| 1881646669 | Shenika L. Marshall-hill | Counselor | 1594 Beaufort Ave. S., Fairfax, SC 29827 | 2006-05-17 |
| 1588623540 | Rebecca Lynn Wilkes | Nurse Practitioner | 333 Revolutionary Trail, Fairfax, SC 29827 | 2006-03-20 |
| 1497745012 | Robert M Haberkorn | Dentist | 1987 Allendale-fairfax Hwy, Fairfax, SC 29827 | 2005-10-25 |
| 1588815021 | James Robert Mynatt | Nurse Practitioner | 333 Revolutionary Trail, Fairfax, SC 29827 | 2008-10-02 |
| 1063607646 | Mol Ky | General Practice | 333 Revolutionary Trail, Fairfax, SC 29827 | 2007-09-07 |
| 1053475566 | Low Country Health Care System, Inc | Pharmacy | 333 Revolutionary Trail, Farifax, SC 29827 | 2006-12-20 |
| Find all providers in zip 29827 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053873240 | Merrifield Dental Associates | Clinic/Center | 3025 Hamaker Ct Ste 420, Fairfax, VA 22031-2237 | 2019-04-05 |
| 1790124949 | Georges Traboulsi Dds PC | Clinic/Center | 3946 Kathryn Jean Ct, Fairfax, VA 22033-2739 | 2013-06-20 |
| 1154606440 | Robert M. Haberkorn Dds | Clinic/Center | 1987 Allendale Fairfax Hwy., Fairfax, SC 29827 | 2011-10-18 |
| 1023287737 | Naturadent, P.C. | Clinic/Center | 9508a Lee Hwy, Fairfax, VA 22031-2303 | 2008-02-27 |
| 1932292877 | William B Sherman Dds PC | Clinic/Center | 9500 B Lee Highway, Fairfax, VA 22031 | 2006-10-02 |
| 1710477815 | Pd Dental Pllc | Clinic/Center | 10721 Main St Ste 100, Fairfax, VA 22030-6913 | 2018-05-14 |
| 1831606086 | Jhia-ming Chang, Dds, PC | Clinic/Center | 11208 Waples Mill Rd Ste 100, Fairfax, VA 22030-6077 | 2018-01-09 |
| 1336661651 | Jones Family Dentistry Pllc | Clinic/Center | 3879 Plaza Dr, Fairfax, VA 22030-2512 | 2017-07-07 |
| 1518330133 | Optimal Dental Center, Inc | Clinic/Center | 8303 Arlington Blvd, Suite 107, Fairfax, VA 22031-2903 | 2015-11-04 |
| 1346651510 | Mojgan Shaafi Dds PC | Clinic/Center | 3541 Chain Bridge Rd Ste 3, Fairfax, VA 22030-2793 | 2014-05-09 |
| Find all providers in FAIRFAX | ||||
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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.