CHAD L WAGSTAFF (NPI# 1730212564) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730212564 |
| Entity Type | Individual |
| Full Name | CHAD L WAGSTAFF |
| Credential | DDS |
| Practice Address |
2640 N Highway 162 Eden UT 84310-9745 |
| Mailing Address |
Po Box 805 2640 N Highway 162 Eden UT 84310-0805 |
| Practice Telephone | 8017451100 |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2014-11-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
019-025276 | IL | Dental Providers |
| Street Address |
2640 N HIGHWAY 162 |
| City | EDEN |
| State | UT |
| Zip Code | 84310-9745 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871626630 | Clw Dds Pllc | Dentist | 2640 N Highway 162, Eden, UT 84310-9745 | 2007-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215493614 | Jared Andrew Rose | Physical Therapist | 2131 N 5500 E, Eden, UT 84310 | 2019-02-11 |
| 1396862801 | Kermit Kim Cowley | Pharmacist | 2555 N. Wolf Creek Drive, Eden, UT 84310 | 2007-03-22 |
| 1346253515 | Roe Rx Inc | Durable Medical Equipment & Medical Supplies | 2555 North Wolf Creek Drive, Eden, UT 84310 | 2006-08-15 |
| 1023019593 | Bradley D Benard | Physical Therapist | 4920 E 2550 N, Unit C, Eden, UT 84310 | 2005-08-09 |
| 1770892366 | Trent C Henderson | Physical Therapist | 4920 E 2550 N, Unit C, Eden, UT 84310 | 2010-09-29 |
| 1003147745 | Michelle Ashby Cherry | Counselor | 2461 N Shady Lane, Eden, UT 84310-1091 | 2010-01-20 |
| 1164061370 | Oak Hill Medical Group LLC | Family Medicine | 6781 N 2100 E, Liberty, UT 84310-4701 | 2020-01-06 |
| 1902101892 | Chun Il Mah | Radiology | 4218 Sunrise Dr, Eden, UT 84310-6764 | 2011-01-24 |
| 1639492978 | Lorrie Harper | Physical Therapist | 4794 E 2600 N, Suite B, Eden, UT 84310-9535 | 2010-03-01 |
| 1013532001 | Aspen Wayment | Student in an Organized Health Care Education/Training Program | 2531 Shaw Dr, Liberty, UT 84310-9705 | 2020-06-15 |
| Find all providers in zip 84310 | ||||
| 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 |
|---|---|---|---|---|
| 1619578846 | Abbey S. Hawkins, Dds, Pa | Dentist | 113 W Arbor Lln, Eden, NC 27288-5305 | 2020-11-04 |
| 1285829796 | Donald Johnston Wright | Dentist | 407 S Van Buren Rd, Eden, NC 27288-5069 | 2007-09-07 |
| 1619180445 | Insook Baik Smith | Dentist | 120b W Arbor Ln, Eden, NC 27288-5306 | 2007-05-08 |
| 1861510927 | Dalyn J Johnson | Dentist | 212 Jackson St., Eden, TX 76837-0246 | 2007-03-27 |
| 1508990268 | Hugh T Dowdy | Dentist | 120 W Arbor Ln, Eden, NC 27288-5306 | 2007-03-15 |
| 1598842890 | Michael D Burleson | Dentist | 113 W Arbor Ln, Eden, NC 27288-5305 | 2006-11-01 |
| 1497844310 | Kamran Hameed | Dentist | 701 S Van Buren Rd, Eden, NC 27288-5321 | 2006-10-11 |
| 1568410405 | Glenn William Horrigan | Dentist | 2553 W Church St, Eden, NY 14057-1005 | 2006-05-04 |
| 1487617940 | Vern Quincy Iverson | Dentist | 2627 N Highway 162, Eden, UT 84310-9745 | 2006-04-07 |
| 1336576818 | Iverson Dental, Inc. | Dentist | 2627 N Highway 162, Eden, UT 84310-9745 | 2013-09-30 |
| Find all providers in EDEN | ||||
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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.