Dr. Kevin Joseph Wagner, DMD
Dentist in Pocatello, ID. Individual provider (NPI-1).
NPI number1558094508
StatusActive
Last updated in NPPESJul 7, 2022
Details
- NPI
- 1558094508
- Entity type
- Individual (NPI-1)
- Name
- Dr. Kevin Joseph Wagner
- Credential
- DMD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 7, 2022
- Certification date
- Jun 27, 2022
- Last updated
- Jul 7, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | D-5422 | ID | Yes |
Practice location
921 S 8th Avenue Stop 8088Pocatello, ID 83201
Phone 609-923-0168
Mailing address
4170 Hawthorne Rd Apt A307Chubbuck, ID 83202-2738
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Dentist providers in Pocatello, ID
- Chloe Burton Birchfield, DMDNPI 1255123451
- Blackrock Dental Partners, PLLCNPI 1356643308
- Spencer Bray, DDSNPI 1346949401
- Paul Michael Cady, DMDNPI 1619235082
- Brady Carlen, DDSNPI 1992320915
- Frederick ChoNPI 1700584794
- Chris Hansen Dmd PANPI 1053632919
- Brent William ClineNPI 1487148979
- Comfort Care DentalNPI 1982086856
- Creighton Holdings PLLCNPI 1518857002
All 42 Dentist providers in Pocatello · All 2,770 providers in Pocatello
Checking a whole list?
Paste a list of NPIs and get status, record, Medicare enrollment and OIG exclusion for each one. 100 free a day, then from $5 for 5,000. Useful for credentialing, billing and pharmacy claim checks.