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Mark Waggonner, DDS
NPI 1578541355 · General Practice Dentistry · Sun City, CA
Mark Waggonner, DDS is a General Practice Dentistry provider in Sun City, CA (NPI 1578541355).
Provider details
- NPI number
- 1578541355
- Entity type
- Individual
- Primary specialty
- General Practice DentistryDental Providers
- Credential
- DDS
- Sex
- Male
- License
- 24189 (CA)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES 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
28401 Bradley Rd
Sun City, CA 92586-3040
Phone: (951) 679-6355
Fax: (951) 679-6355
Street-level locationGet directions
Mailing address
12020 Paradise St
Grand Terrace, CA 92313-5335
Registry dates
- Enumerated
- 2006-01-03
- Last updated
- 2007-07-08
Frequently asked questions
- What is Mark Waggonner's NPI number?
- Mark Waggonner's National Provider Identifier (NPI) is 1578541355, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Mark Waggonner's specialty?
- Mark Waggonner is listed in the NPPES registry with a primary specialty of General Practice Dentistry (Dental Providers).
- Where is Mark Waggonner located?
- Mark Waggonner's practice location on file with NPPES is 28401 Bradley Rd, Sun City, CA 92586-3040.
- What is Mark Waggonner's phone number?
- The practice phone number listed in the NPPES registry for Mark Waggonner is (951) 679-6355.
- Is Mark Waggonner's NPI active?
- Yes — Mark Waggonner's NPI (1578541355) is active in the NPPES registry as of the last update on 2007-07-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.