Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr Wagner Southridge Optical LLC

Organization Eyewear Supplier · NPI 1255591236

Dr Wagner Southridge Optical LLC is an Eyewear Supplier in Greendale, Wisconsin. Registered with an NPI since 2008.

In the registry since
2008
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

5300 S 76th St Ste 690
Greendale, WI 53129-1102
Phone: (414) 855-0469
Fax: (414) 855-0492
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Eyewear Supplier (primary) Taxonomy 332H00000X

Record details

NPI number1255591236
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Joan Serrano — Manager · (414) 855-0469
NPI enumeratedJune 12, 2008
Last updated in NPPESAugust 17, 2009
Mailing address5300 S 76th St, Ste 690, Greendale, WI 53129-1102

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