LESLIE A WAGNER


Address: 1212 N Cole Rd, Boise, ID 83704-8646
Phone: 2089017451

LESLIE A WAGNER (NPI# 1639699036) 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) 1639699036
Entity Type Individual
Full Name LESLIE A WAGNER
Practice Address 1212 N Cole Rd
Boise
ID 83704-8646
Mailing Address 4239 E Hardesty Ct
Boise
ID 83716
Practice Telephone 2089017451
Mailing Telephone 2088695139
Enumeration Date 2017-06-27
Last Update Date 2018-03-17
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223G0001X Dentist
Specialization: General Practice
D4846 ID Dental Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
8850 W Emerald St Ste 150, Boise, ID 837044809 2083232294

Other Providers LESLIE WAGNER

NPI Name Taxonomy Address Enumeration
1720293723 Leslie Wagner Speech-Language Pathologist 55 Tiemann Pl, Apt # 55, New York, NY 10027-3332 2007-05-11
1023139326 Leslie Michelle Wagner Massage Therapist 2710 Civic Cir, Amarillo, TX 79109-1648 2007-04-03
1013033398 Leslie Ann Wagner Psychologist 533 Saint Clair St, Grosse Pointe, MI 48230-1503 2007-03-21
1740788397 Leslie Wagner Speech-Language Pathologist 3501 Taylor Ave, Baltimore, MD 21236-4406 2018-01-30
1952841678 Leslie Wagner Social Worker 658 Kenilworth Dr, Suite 206, Towson, MD 21204-2312 2017-02-28
1033303938 Leslie Wagner Registered Nurse 9333 Tech Center Dr, Suite 800, Sacramento, CA 95826-2583 2007-09-04

Office Location

Street Address 1212 N COLE RD
City BOISE
State ID
Zip Code 83704-8646

Providers in the same location

NPI Name Taxonomy Address Enumeration
1710057211 Trotter Vaughan Dentist 1212 N Cole Rd, Boise, ID 83704-8646 2006-11-09
1346634870 Hd Boise Dental, LLC Dentist 1212 N Cole Rd, Boise, ID 83704-8646 2015-03-23
1881039709 Blanchard Dds PC Clinic/Center 1212 N Cole Rd, Boise, ID 83704-8646 2013-05-06
1710164793 Art Dental Dentist 1212 N Cole Rd, Boise, ID 83704-8646 2008-01-22
1568580074 Bradley Robertson Dentist 1212 N Cole Rd, Boise, ID 83704-8646 2007-03-26

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1215535893 Laura Diggs Counselor 400 North Benjamin Lane, Suite 200, Boise, ID 83704 2020-10-15
1891304002 Tree City Family Dental Dentist 7301 W. Emerald St Ste. 102, Boise, ID 83704 2020-07-24
1982230710 Jessica Wynn Councell Midwife 1072 N Liberty St Ste 100, Boise, ID 83704 2020-03-12
1699307124 Isabel Burns Bruce Registered Nurse 777 N Raymond Street, Boise, ID 83704 2020-02-12
1558903328 Daring In Idaho, LLC Social Worker 413 N Allumbaugh Street, Suite 102, Boise, ID 83704 2019-10-14
1053960286 Kyle Hiromi Hatanaka Acupuncturist 9450 #120 Fairview Avenue, Boise, ID 83704 2019-09-10
1700447141 Katie Elizabeth Nichols Physician Assistant 1072 N Liberty St Ste 201, Boise, ID 83704 2019-06-26
1588164727 Cory Michael Sims Counselor 6550 W. Emerald St #112, Boise, ID 83704 2018-02-14
1477072270 Matthew Lee Love Non-emergency Medical Transport (VAN) 6933 W. Stratton St, Boise, ID 83704 2017-09-12
1942735949 Dalana Sue Thompson Counselor 9196 Emerald St Suite #130, Boise, ID 83704 2017-04-27
Find all providers in zip 83704

Taxonomy Information

Taxonomy Code 1223G0001X
Grouping Dental Providers
Classification Dentist
Specialization General Practice

Taxonomy Definition

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

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1588273635 Atlantis Dental Care, P.a. Dentist 13238 W Persimmon Ln Ste 100, Boise, ID 83713-1968 2020-07-24
1235747338 Dentists of Boise and Orthodontics, PC Dentist 7500 W State St Ste 110, Boise, ID 83714-6074 2020-07-15
1346895232 Tejasi Avasare Dentist 8321 W Overland Rd, Boise, ID 83709-1640 2019-08-07
1528610359 Melissa Marie Pysnak Dentist 8850 W Emerald St Ste 150, Boise, ID 83704-4809 2019-07-11
1124684584 Trevor Tafoya Dds Victory Dental, Pllc Dentist 7421 W Victory Rd, Boise, ID 83709-5106 2019-05-11
1982260360 Brant Burbank Dentist 4255 N Eagle Rd Ste 102, Boise, ID 83713-0701 2019-05-11
1972023398 Northview Dental Partnership LLC Dentist 7480 W Northview St, Boise, ID 83704-7232 2017-06-27
1962939421 Travis Jon Weimer Dentist 8336 W Northview St, Boise, ID 83704-7132 2017-05-16
1922480284 Jonathan W Pluid Dentist 4274 N Eagle Rd, Boise, ID 83713-0726 2015-06-23
1922489673 Gray Team LLC Dentist 813 N Stilson Rd, Ste:b, Boise, ID 83703-5119 2015-06-17
Find all providers in BOISE

Competitor

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City BOISE
Zip Code 83704

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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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