DR. ROBERT GENE WAGONER II (NPI# 1740368935) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740368935 |
| Entity Type | Individual |
| Full Name | DR. ROBERT GENE WAGONER II |
| Credential | DMD MD |
| Practice Address |
801 N. Elm Street Henderson KY 42420-2705 |
| Practice Telephone | 2702120330 |
| Practice Fax Number | 2702120332 |
| Mailing Telephone | 2702120330 |
| Mailing Fax Number | 2702120332 |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2012-09-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
7298 | KY | Dental Providers |
| Y | 204E00000X | Oral & Maxillofacial Surgery | 7298 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 60002003 | 05 | |
| KY | 64063514 | 05 | |
| KY | ANTHEM BLUE CROSS BLUE SH | 000000299338 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568551265 | Robert Luke Wagoner | Optometrist | 885 S Governors Ave, Dover, DE 19904-4158 | 2006-10-12 |
| Street Address |
801 N. ELM STREET |
| City | HENDERSON |
| State | KY |
| Zip Code | 42420-2705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174136337 | Virtual Consult Md LLC | Psychiatry & Neurology | 2202 Hwy 41 North, Unit E 152, Hendereson, KY 42420 | 2020-08-27 |
| 1679062731 | Maranda Wortham Miles | Nurse Practitioner | 2242 Hwy 41 North, Henderson, KY 42420 | 2018-05-04 |
| 1780124297 | Lisa Lovell | Nurse Practitioner | 230 North Green Street, Henderson, KY 42420 | 2017-03-02 |
| 1437540614 | Kala Hovermale | Social Worker | 220 2nd Street Ste 406, Henderson, KY 42420 | 2015-02-10 |
| 1972991537 | Jessica Thomas | Counselor | 230 Second St, Suite 406, Henderson, KY 42420 | 2015-01-06 |
| 1255690962 | Green River District Health Department | Public Health or Welfare | 631 N. Green Street, Henderson, KY 42420 | 2012-05-15 |
| 1588922769 | Jonathan M Mosley | Family Medicine | 1200 Barrett Blvd, Henderson, KY 42420 | 2012-04-25 |
| 1093099731 | Gregory Ayuk | Pharmacist | 402 Second Street, Henderson, KY 42420 | 2011-09-29 |
| 1437488137 | Peter J. Doll, D.p.m. | Durable Medical Equipment & Medical Supplies | 323 8th St., Henderson, KY 42420 | 2009-12-09 |
| 1760626402 | Linda Dalton Keith | Nurse Practitioner | 1704 2nd St, Henderson, KY 42420 | 2009-04-24 |
| Find all providers in zip 42420 | ||||
| Taxonomy Code | 204E00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Oral & Maxillofacial Surgery |
| Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. |
| Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447857024 | Sudheer J. Surpure, Md, Dds, Inc. | Oral & Maxillofacial Surgery | Grand Canyon Oral and Facial Surgery, 1600 W. Sunset Road, Suite B, Henderson, NV 89014 | 2020-10-06 |
| 1174570816 | Katherine A Keeley | Oral & Maxillofacial Surgery | 2649 Wigwam Pkwy, Suite 102, Henderson, NV 89074-7310 | 2006-05-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457847691 | Kentucky Center for Oral & Maxillofacial Surgery Psc | Oral & Maxillofacial Surgery | 2424 Sir Barton Way Ste 375, Lexington, KY 40509-2521 | 2018-07-10 |
| 1750552733 | Romeo N. Laureano, D.m.d., P.s.c. | Oral & Maxillofacial Surgery | 120 W Stephen Foster Ave Ste 107, Bardstown, KY 40004-1457 | 2008-03-18 |
| 1831225465 | Jackson Ent Clinic, Psc | Oral & Maxillofacial Surgery | 1550 Highway 15 S Ste 29, Jackson, KY 41339-9221 | 2007-02-26 |
| 1295861524 | William R Anderson Dmd Psc | Oral & Maxillofacial Surgery | 972 Broadway Plaza, Paintsville, KY 41240 | 2007-02-23 |
| 1427145366 | C Michael Brinker | Oral & Maxillofacial Surgery | 8172 Mall Road, Suite 214, Florence, KY 41042 | 2006-10-10 |
| 1629081385 | Tariq A Sartawi | Oral & Maxillofacial Surgery | 1550 Hwy 15 South, Suite #29, Jackson, KY 41339-0768 | 2006-08-14 |
| 1801892047 | David L Wells II | Oral & Maxillofacial Surgery | 2250 Leestown Rd, Veterans Affairs Medical Center-ld Dept of Admin Med, Lexington, KY 40511 | 2005-06-22 |
| 1922480250 | Commonwealth Oral and Maxillofacial Surgery, Psc | Oral & Maxillofacial Surgery | 6520 Glenridge Park Pl, Suite 7, Louisville, KY 40222-3455 | 2015-06-23 |
| 1285942649 | Erena & Peterson, Pllc | Oral & Maxillofacial Surgery | 620 Perimeter Dr, Suite 100, Lexington, KY 40517-4125 | 2010-09-20 |
| 1760706675 | Edyee M Sturgill, Dmd, Md | Oral & Maxillofacial Surgery | 895 Wilkinson Trce Ste B, Bowling Green, KY 42103-2486 | 2010-03-22 |
| Find all providers with the same taxonomy | ||||
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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.