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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MICHAEL A WAGNER DDS
NPI 1639114622
Dentist in Pawtucket, RI

Active since June 17, 2006
480 BROADWAY, PAWTUCKET, RI 02860(401) 728-6654(701) 728-5726 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Michael A Wagner Dds NPPES

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

MICHAEL A WAGNER DDS (NPI 1639114622) is an individual dentist in Pawtucket, Rhode Island, licensed in Rhode Island (2342) and active in the NPI registry since June 2006.

NPPES Registry Identity

NPI1639114622
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameMICHAEL A WAGNERCredential: DDS
Location Address480 BROADWAYPawtucket, RI 02860
Mailing Address480 BroadwayPawtucket, RI 02860 · (401) 728-6654 · Fax (701) 728-5726
Phone(401) 728-6654
Fax(701) 728-5726
Sole ProprietorNo
Enumeration DateJune 17, 2006
Last NPPES UpdateJuly 13, 2026
✔ NPI 1639114622 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in RI · 2342
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
480 BROADWAY, Pawtucket, RI 02860
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Other Identifiers 1

MedicaidMW02273RI

Other Providers at the Same Location NPPES

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

THE FAMILY DENTIST
Dentist
480 BROADWAY
PAWTUCKET, RI 02860
Providence County (401) 728-6654

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 Michael Wagner's NPI number?

The NPI number for Michael Wagner is 1639114622. It was assigned to this individual provider in the NPPES registry on June 17, 2006.

Where is Michael Wagner located?

Michael Wagner practices at 480 Broadway, Pawtucket, RI 02860. The listed phone number is (401) 728-6654.

What is Michael Wagner's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

When was this NPI record last updated?

The NPPES record for Michael Wagner was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 52 days 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.