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

Charles Allen Wagner, DDS

Individual provider General Practice Dentistry · NPI 1982760153

Charles Allen Wagner, DDS is a General Practice Dentistry in Idaho Falls, Idaho. Works from 2 locations. Licensed in Idaho and Oregon.

Licensed in
ID, OR
In the registry since
2006
Specialties on file
2
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

2860 Valencia Dr
Idaho Falls, ID 83404-7597
Phone: (855) 433-6825
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 773 Golf View Dr, Medford, OR 97504-9643 — (541) 857-2790

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 2971138 (ID)
General Practice Dentistry Taxonomy 1223G0001X · Licence D7442 (OR)

Record details

NPI number1982760153
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedDecember 29, 2006
Last updated in NPPESJuly 29, 2026
Certification dateJuly 29, 2026

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