Alexis Dawn Wagoner in Longview - Dental Assistant
Alexis Dawn Wagoner - NPI 1083700231
Alexis Dawn Wagoner is a Dental Assistant in Longview, Washington. Alexis Dawn Wagoner practices all healthcare services and medical treatments related to Dental Assistant. The NPI Number for Alexis Dawn Wagoner is 1083700231. The last update date is 2007-07-08.
Alexis Dawn Wagoner's current location address is 3902 Cottonwood St, Longview, Washington. You can contact this provider via phone number 3604257753. The mailing address for Alexis Dawn Wagoner is 3902 Cottonwood St, Longview, Washington. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Alexis Dawn Wagoner |
|---|---|
| Address | 3902 Cottonwood St, Longview, Washington |
| Phone Number | 3604257753 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | DA |
NPI Number Detail
| NPI Number | 1083700231 |
|---|---|
| Provider Enumeration Date | 2006-10-05 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 3902 Cottonwood St |
|---|---|
| City | Longview |
| State | Washington (WA) |
| Post Code | 986324911 |
| Phone Number | 3604257753 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Dental Assistant |
|---|---|
| Taxonomy | 126800000X |
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Definition: An individual who may or may not have completed an accredited dental assisting education program and who aids the dentist in providing patient care services and performs other nonclinical duties in the dental office or other patient care facility. Th |
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What is the unique 10-digit identification code assigned to Alexis Dawn Wagoner by the Centers for Medicare & Medicaid Services?
The Alexis Dawn Wagoner has been issued the NPI (National Provider Identifier) 1083700231, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Alexis Dawn Wagoner's physical address?
The Alexis Dawn Wagoner is physically located at 3902 Cottonwood St, in the city of Longview, WA, with the postal code 986324911.
What is Alexis Dawn Wagoner's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Alexis Dawn Wagoner is Dental Assistant, and the taxonomy code that classifies this field of practice is 126800000X.
On what date did the Alexis Dawn Wagoner receive its 1083700231 assignment from the Centers for Medicare & Medicaid Services?
The Alexis Dawn Wagoner was assigned its 1083700231 by the Centers for Medicare & Medicaid Services on 2006-10-05.
As of what date were the details related to Alexis Dawn Wagoner most recently updated or revised?
The information pertaining to Alexis Dawn Wagoner, including its address, specialty, and other relevant details, was last updated or revised on 2007-07-08.