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DR. THOMAS WILSON WAGGENER D.D.S.
NPI 1629166798
Dentist - General Practice in Waco, TX

Active since October 11, 2006PECOS Enrolled
4535 LAKE SHORE DR, WACO, TX 76710(254) 776-7622(254) 776-7673 Get Directions Write a Review

NPPES record last updated: November 11, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Thomas Wilson Waggener D.d.s. NPPES

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

DR. THOMAS WILSON WAGGENER D.D.S. (NPI 1629166798) is an individual general practice provider in Waco, Texas, licensed in Texas (11868) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1629166798
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. THOMAS WILSON WAGGENERCredential: D.D.S.
Location Address4535 LAKE SHORE DRWaco, TX 76710-1814
Mailing Address4535 Lake Shore DrWaco, TX 76710-1814 · (254) 776-7622 · Fax (254) 776-7673
Phone(254) 776-7622
Fax(254) 776-7673
Sole ProprietorYes
Enumeration DateOctober 11, 2006
Last NPPES UpdateNovember 11, 2016
✔ NPI 1629166798 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in TX · 11868
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
4535 LAKE SHORE DR, Waco, TX 76710
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Other Identifiers 1

Medicaid0086746-01TX

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Thomas Wilson Waggener D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76710 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

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

LAKE SHORE DENTAL GROUP PLLC
Dentist (General Practice)
4535 LAKE SHORE DR
WACO, TX 76710
McLennan County (254) 776-7622
LAKE SHORE DENTAL CARE, PLLC
Clinic/Center (Dental)
4535 LAKE SHORE DR
WACO, TX 76710
McLennan County (254) 414-0928

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 Thomas Waggener's NPI number?

The NPI number for Thomas Waggener is 1629166798. It was assigned to this individual provider in the NPPES registry on October 11, 2006.

Where is Thomas Waggener located?

Thomas Waggener practices at 4535 Lake Shore Dr, Waco, TX 76710. The listed phone number is (254) 776-7622.

What is Thomas Waggener's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Thomas Waggener enrolled in Medicare?

Yes. Thomas Waggener is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Thomas Waggener was last updated on November 11, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.