WAGONER FAMILY DENTAL, PLLC
NPI 1669245577
Dentist - General Practice in Wagoner, OK

NPI Status: Active since November 02, 2023

Contact Information

302 S HAYES AVE
WAGONER, OK
ZIP 74467
Phone: (918) 485-3371

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  • Organization
  • Dentist
  • General Practice
  • Accepts Insurance
  • CLIA Number: 37D2089428
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 12-29-2026

About WAGONER FAMILY DENTAL, PLLC

This page provides the complete NPI Profile along with additional information for Wagoner Family Dental, Pllc, a provider established in Wagoner, Oklahoma operating as a Dentist, focusing in general practice . The healthcare provider is registered in the NPI registry with number 1669245577 assigned on November 2023. The practitioner's primary taxonomy code is 1223G0001X. The provider is registered as an organization and their NPI record was last updated 3 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Lily Davis (Credentialing Manager)

NPI
1669245577
Provider Name
WAGONER FAMILY DENTAL, PLLC
Entity Type
Organization
Location Address
302 S HAYES AVE WAGONER, OK 74467
Location Phone
(918) 485-3371
Mailing Address
400 RIVERWALK TER STE 250 JENKS, OK 74037
Mailing Phone
(918) 998-0996
Mailing Fax
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
11-02-2023
Last Update Date
11-02-2023
Code Navigator

A dentist like Wagoner Family Dental, Pllc is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Dentist General Practice

Taxonomy Code
1223G0001X
Type
Dental Providers
Taxonomy Description
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.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Lone Star - Smile Now - PPO
  • Smile Now Arizona - No Waiting Period PPO - PPO
  • Smile Now Michigan - No Waiting Period PPO - PPO
  • Smile Now Ohio - No Waiting Period PPO - PPO
  • Smile Now Texas- No Waiting Period Plan - PPO
  • Smile Now Utah - No Waiting Period PPO - PPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

LILY DAVIS

Authorized Official Title
CREDENTIALING MANAGER
Authorized Official Phone
(918) 998-0996

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
37D2089428
Facility Type
Physician Office
Certificate Effective Date
December 30, 2024
Certificate Expiration Date
December 29, 2026
Laboratory Director
DAVID GOOD
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Wagoner Family Dental, Pllc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1669245577, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 63. The final step is to find the difference between that total and the next multiple of ten (70 - 63 = 7).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
6
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
9
Unchanged
Pos 5
2
Doubled → 4
Pos 6
4
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
5
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
7
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 2 → 4 5 → 10 → 1 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 6 + 1 + 2 + 9 + 4 + 4 + 1 + 0 + 5 + 1 + 4 + 24 = 63

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 63 is 70. The difference is the calculated check digit.

70 - 63 = 7
This NPI is valid
The calculated check digit is 7, which matches the last digit of 1669245577.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Dentist (General Practice)
302 S HAYES AVE
WAGONER, OK 74467
Dentist
302 S HAYES AVE
WAGONER, OK 74467

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1669245577, enumerated as an "organization" on November 02, 2023.

The provider is located at 302 S HAYES AVE WAGONER, OK 74467 and the phone number is (918) 485-3371.

Dentist with taxonomy code 1223G0001X and a focus in General Practice.

The provider might be accepting Accepts: UnitedHealthcare. Please consult your insurance carrier or call the provider to verify.