OrganizationActive
Wagoner Family Dental, PLLC
NPI 1669245577 · General Practice Dentistry · Wagoner, OK
Wagoner Family Dental, PLLC is a General Practice Dentistry organization in Wagoner, OK (NPI 1669245577).
Provider details
- NPI number
- 1669245577
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Lily Davis, Credentialing Manager(918) 998-0996
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(57/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 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
302 S Hayes Ave
Wagoner, OK 74467-5551
Phone: (918) 485-3371
Street-level locationGet directions
Mailing address
400 Riverwalk Ter Ste 250
Jenks, OK 74037-5619
Registry dates
- Enumerated
- 2023-11-02
- Last updated
- 2023-11-02
- Certified
- 2023-11-02
Frequently asked questions
- What is Wagoner Family Dental, PLLC's NPI number?
- Wagoner Family Dental, PLLC's National Provider Identifier (NPI) is 1669245577, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Wagoner Family Dental, PLLC?
- Wagoner Family Dental, PLLC is classified in the NPPES registry as General Practice Dentistry (Dental Providers).
- Where is Wagoner Family Dental, PLLC located?
- Wagoner Family Dental, PLLC's practice location on file with NPPES is 302 S Hayes Ave, Wagoner, OK 74467-5551.
- What is Wagoner Family Dental, PLLC's phone number?
- The practice phone number listed in the NPPES registry for Wagoner Family Dental, PLLC is (918) 485-3371.
- Who is the authorized official for Wagoner Family Dental, PLLC?
- The authorized official listed on Wagoner Family Dental, PLLC's NPPES record is Lily Davis, Credentialing Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Wagoner Family Dental, PLLC's NPI active?
- Yes — Wagoner Family Dental, PLLC's NPI (1669245577) is active in the NPPES registry as of the last update on 2023-11-02.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.