STEPHEN A. WAGNER DDS,PC (NPI# 1932332285) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932332285 |
| Entity Type | Organization |
| Organization Name | STEPHEN A. WAGNER DDS,PC |
| Practice Address |
801 Encino Pl Ne Ste A3 Albuquerque NM 87102-2639 |
| Practice Telephone | 5052323588 |
| Practice Fax Number | 5052323593 |
| Mailing Telephone | 5052323588 |
| Mailing Fax Number | 5052323593 |
| Enumeration Date | 2009-09-02 |
| Last Update Date | 2009-09-02 |
| Authorized Official Name | DR. STEPHEN A WAGNER (MAXILLOFACIAL PROSTHODONTIST) |
| Authorized Official Telephone | 5052323588 |
| Authorized Official Credential | DDS,PC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
DD1150 | NM | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 82743 | 05 |
| Street Address |
801 ENCINO PL NE STE A3 |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87102-2639 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730512245 | Diana N Ulrickson | Dentist | 801 Encino Pl Ne Ste A3, Albuquerque, NM 87102-2639 | 2013-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407454937 | Julie Wood | Acupuncturist | 1600 Luna Circle Nw, Albuquerque, NM 87102 | 2020-10-16 |
| 1770121410 | Emily Perez | Counselor | 218 Broadway Ne, Albuquerque, NM 87102 | 2019-12-12 |
| 1417503392 | Tess Holtry | Behavior Technician | 1424 Walter St Nw, Albuquerque, NM 87102 | 2019-08-15 |
| 1942867486 | Christy E Cheromiah | Behavioral Analyst | Open Skies Helathcare, 707 Broadway Blvd Ne, Albuquerque, NM 87102 | 2019-05-21 |
| 1730744103 | Faith Petra Maxwell | Behavior Technician | 900 Arno St, Albuquerque, NM 87102 | 2019-05-01 |
| 1568923761 | Storm Swinford | Behavioral Analyst | Open Skies Healthcare, 707 Broadway Blvd Ne, Albuquerque, NM 87102 | 2019-03-29 |
| 1093276651 | Tina Marie Trujillo | Behavioral Analyst | Open Skies Health Care, 707 Broadway Blvd Ne, Albuquerque, NM 87102 | 2019-03-27 |
| 1861950370 | Meghan Montoya | Student in an Organized Health Care Education/Training Program | 801 Camino De Salud, Albuquerque, NM 87102 | 2019-03-05 |
| 1174099329 | Dilshani N Tyson | Counselor | 600 1st Street Nw Ste 200, Albuquerque, NM 87102 | 2018-10-15 |
| 1962987925 | Tania L Goldfeder | Social Worker | New Mexico Solutions, 707 Broadway Ne Suite 500, Albuquerque, NM 87102 | 2018-09-26 |
| Find all providers in zip 87102 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124512488 | Stacey Montano Dds LLC | Clinic/Center | 3901 Georgia St Ne Ste G1, Albuquerque, NM 87110-1388 | 2018-06-20 |
| 1003300393 | Napa Dental Management, LLC | Clinic/Center | 10820 Comanche Rd Ne Ste D, Albuquerque, NM 87111-3983 | 2018-06-19 |
| 1871042457 | Dental House Trade Winds, LLC | Clinic/Center | 5400 Central Ave Se, Suite C-101, Albuquerque, NM 87108-1502 | 2016-09-24 |
| 1528437258 | Anywhere Dental Care | Clinic/Center | 28 Canada De Los Alamos Trl Se, Albuquerque, NM 87123-9504 | 2015-09-23 |
| 1871961045 | Gregory R Mcallister, Dds, LLC | Clinic/Center | 5910 Cubero Dr Ne Ste B, Albuquerque, NM 87109-3868 | 2015-09-04 |
| 1003299173 | Sunshine Dental, PC | Clinic/Center | 10411 Lagrima De Oro Rd Ne, Albuquerque, NM 87111-3727 | 2015-07-07 |
| 1356690788 | Alegre Dental | Clinic/Center | 2116 Vista Oeste Nw #202, Albuquerque, NM 87120 | 2012-08-30 |
| 1215243985 | Dr. David J Harnick D.d.s.,m.s.d. | Clinic/Center | 8631 Golf Course Rd Nw Ste F, Albuquerque, NM 87114-6347 | 2010-08-19 |
| 1447427513 | Uptown Park Dental Practice, LLC | Clinic/Center | 2100 Louisiana Blvd Ne, Suite 104, Albuquerque, NM 87110-5419 | 2008-05-08 |
| 1013193622 | Comfort Dental of Coronado | Clinic/Center | 5820 Menaul Blvd. Ne, Albuquerque, NM 87110-3238 | 2008-01-14 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87102 |
Please comment or provide details below to improve the information on STEPHEN A. WAGNER DDS,PC.
| 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.