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

Wagoner Family Dental, PLLC

Organization General Practice Dentistry · NPI 1669245577

Wagoner Family Dental, PLLC is a General Practice Dentistry in Wagoner, Oklahoma. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

302 S Hayes Ave
Wagoner, OK 74467-5551
Phone: (918) 485-3371
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X

Record details

NPI number1669245577
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lily Davis — Credentialing Manager · (918) 998-0996
NPI enumeratedNovember 2, 2023
Last updated in NPPESNovember 2, 2023
Certification dateNovember 2, 2023
Mailing address400 Riverwalk Ter Ste 250, Jenks, OK 74037-5619

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