Jon Dagley Wagner, MD DDS is a
Dentist - Oral And Maxillofacial Surgery physician based in Albuquerque, New Mexico. Jon Dagley Wagner is licensed to practice in New Mexico (license number DD3842) and his current practice location is 10000 Coors Byp Nw, Suite G-218, Albuquerque, New Mexico. He can be reached at his office (for appointments etc.) via phone at
(505) 242-4867.
NPI number for Jon Dagley Wagner is 1154338101 and his current mailing address is 10000 Coors Byp Nw, Suite G-218, Albuquerque, New Mexico. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1154338101.
Physician's Profile
| Full Name | Jon Dagley Wagner |
|---|
| Gender | Male |
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| Speciality | Dentist - Oral And Maxillofacial Surgery |
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| Location | 10000 Coors Byp Nw, Albuquerque, New Mexico |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1154338101
- Provider Enumeration Date: 08/02/2006
- Last Update Date: 04/04/2013
Medical Identifiers
Medical identifiers for Jon Dagley Wagner such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1154338101 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208200000X | Plastic Surgery | 95-367 (Texas) | Secondary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | DD3842 (New Mexico) | Primary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 28634 (Texas) | Secondary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 055441-1 (New York) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jon Dagley Wagner is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jon Dagley Wagner, MD DDS
10000 Coors Byp Nw, Suite G-218,
Albuquerque, NM 87114-4040
Ph: (505) 242-4867 | Jon Dagley Wagner, MD DDS
10000 Coors Byp Nw, Suite G-218,
Albuquerque, NM 87114-4040
Ph: (505) 242-4867 |
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