IndividualActive
Jacob Wagner, D.D.S.
NPI 1538017140 · Dentist · Crandon, WI
Provider details
- NPI number
- 1538017140
- Entity type
- Individual
- Primary specialty
- DentistDental Providers
- Credential
- D.D.S.
- Sex
- Male
- Sole proprietor
- No
- License
- 6002171-15 (WI)
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(53/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
8201 Mish Ko Swen Dr
Crandon, WI 54520-8631
Phone: (608) 206-9268
Street-level locationGet directions
Mailing address
8201 Mish Ko Swen Dr
Crandon, WI 54520-8631
Registry dates
- Enumerated
- 2026-03-19
- Last updated
- 2026-06-04
- Certified
- 2026-06-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.