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DR WAGNER SOUTHRIDGE OPTICAL LLC
NPI 1255591236
Eyewear Supplier in Greendale, WI

Active since June 12, 2008
5300 S 76TH ST, STE 690, GREENDALE, WI 53129(414) 855-0469(414) 855-0492 Get Directions Write a Review

NPPES record last updated: August 17, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr Wagner Southridge Optical Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR WAGNER SOUTHRIDGE OPTICAL LLC (NPI 1255591236) is a healthcare organization registered as an eyewear supplier in Greendale, Wisconsin and active in the NPI registry since June 2008. The organization lists Joan E Serrano, Manager, as its authorized official.

NPPES Registry Identity

NPI1255591236
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameDR WAGNER SOUTHRIDGE OPTICAL LLC
Location Address5300 S 76TH ST, STE 690Greendale, WI 53129-1102
Mailing Address5300 S 76th St, Ste 690Greendale, WI 53129-1102 · (414) 855-0469 · Fax (414) 855-0492
Phone(414) 855-0469
Fax(414) 855-0492
Organization SubpartNo
Authorized OfficialJoan E SerranoManager · (414) 855-0469
Enumeration DateJune 12, 2008
Last NPPES UpdateAugust 17, 2009
✔ NPI 1255591236 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEyewear SupplierSuppliers
Taxonomy Code332H00000X
Definition
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
5300 S 76TH ST, Greendale, WI 53129
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Other Identifiers 3

Medicare UPINT21464WI
Medicare NSC4800030001WI
Medicare PIN000427289WI

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JOHN MONTY OD
Optometrist
5300 S 76TH ST
GREENDALE, WI 53129
Milwaukee County (414) 421-9330
VISIONWORKS, INC.
Eyewear Supplier
5300 S 76TH ST
GREENDALE, WI 53129
Milwaukee County (414) 421-6450
DR. NEBOJSA VESIC OD
Optometrist
5300 S 76TH ST
GREENDALE, WI 53129
Milwaukee County (414) 421-6450
PEARLE VISION INC
Optometrist
5300 S 76TH ST
GREENDALE, WI 53129
Milwaukee County (414) 421-9330
MICHAEL LINDEMEYER OD
Optometrist
5300 S 76TH ST
GREENDALE, WI 53129
Milwaukee County (414) 421-6450
STEIN OPTICAL INC
Eyewear Supplier
5300 S 76TH ST
GREENDALE, WI 53129
Milwaukee County (414) 421-6450
DR. JAMES P WAGNER OD
Optometrist
5300 S 76TH ST, STE 690
GREENDALE, WI 53129
Milwaukee County (414) 855-0469
PLAYLAB COLLECTIVE, INC
Speech-Language Pathologist
5300 S 76TH ST
GREENDALE, WI 53129
Milwaukee County (262) 497-7270

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dr Wagner Southridge Optical LLC's NPI number?

The NPI number for Dr Wagner Southridge Optical LLC is 1255591236. It was assigned to this organization in the NPPES registry on June 12, 2008.

Where is Dr Wagner Southridge Optical LLC located?

Dr Wagner Southridge Optical LLC is located at 5300 S 76th St Ste 690, Greendale, WI 53129. The listed phone number is (414) 855-0469.

What is Dr Wagner Southridge Optical LLC's specialty?

The primary specialty registered for this NPI is Eyewear Supplier with taxonomy code 332H00000X.

When was this NPI record last updated?

The NPPES record for Dr Wagner Southridge Optical LLC was last updated on August 17, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.