Dr. Keith Dineen Wagner, M.D.
Dr. Keith Dineen Wagner is a Dermatology Physician provider (Dermatology) practicing in Appleton, WI, registered in the NPPES registry with NPI 1760047112 since 2019. The credential MD stands for Doctor of Medicine. Practices at Forefront Dermatology, S.C. (listed at the same practice address in NPPES).
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1760047112 |
|---|---|
| Entity type | Individual (Type 1) |
| Name | Dr. Keith Dineen Wagner |
| Credential | M.D. |
| Sex | Male |
| Practice address | 3935 N LIGHTNING DR, Appleton, WI, 54913 |
| Phone | 9209681790 |
| Fax | 9209681794 |
| Enumeration date | 2019-05-01 |
| Last updated in NPPES | 2023-09-11 |
Taxonomy & licenses
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 207N00000X | Dermatology Physician | Primary | 82425-20 | WI |
MD — Doctor of Medicine: A physician who completed medical school (allopathic medicine), residency training, and state licensure. About the MD credential
Copy-ready billing details
Provider: Keith Wagner, M.D. NPI: 1760047112 Taxonomy: 207N00000X (Dermatology Physician) Address: 3935 N LIGHTNING DR, Appleton, WI, 54913
Other providers at this practice address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1083768253 | Forefront Dermatology, S.C. | Organization | Dermatology Physician | Appleton, WI |
| 1477725141 | Peter Katz | Individual | Dermatology Physician | Appleton, WI |
| 1972863389 | Noah Smith | Individual | Dermatology Physician | Appleton, WI |
| 1053806083 | Hillary Ahola-Jacques | Individual | Physician Assistant | Appleton, WI |
Verify this record
Cross-check NPI 1760047112 against the authoritative CMS record: view Dr. Keith Dineen 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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Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2023-09-11.