Michael A Wagner, DDS
Michael A Wagner is a Dentist provider (Dentist) practicing in Pawtucket, RI, registered in the NPPES registry with NPI 1639114622 since 2006. The credential DDS stands for Doctor of Dental Surgery. Practices at The Family Dentist (listed at the same practice address in NPPES).
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1639114622 |
|---|---|
| Entity type | Individual (Type 1) |
| Name | Michael A Wagner |
| Credential | DDS |
| Sex | Male |
| Practice address | 480 BROADWAY, Pawtucket, RI, 02860 |
| Phone | 4017286654 |
| Fax | 7017285726 |
| Enumeration date | 2006-06-17 |
| Last updated in NPPES | 2007-07-08 |
Taxonomy & licenses
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 122300000X | Dentist | Primary | 2342 | RI |
DDS — Doctor of Dental Surgery: A licensed dentist; DDS and DMD are equivalent dental degrees. About the DDS credential
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MW02273 | Medicaid | RI | — |
Copy-ready billing details
Provider: Michael Wagner, DDS NPI: 1639114622 Taxonomy: 122300000X (Dentist) Address: 480 BROADWAY, Pawtucket, RI, 02860
Other providers at this practice address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1013164920 | The Family Dentist | Organization | Dentist | Pawtucket, RI |
Verify this record
Cross-check NPI 1639114622 against the authoritative CMS record: view Michael A Wagner on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
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Is NPI 1639114622 active?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2007-07-08.