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

Dr. Brandon Mark Wagner, DDS

Individual provider General Practice Dentistry · NPI 1265002901

Dr. Brandon Mark Wagner, DDS is a General Practice Dentistry in Boise, Idaho. Practices as a sole proprietor. Licensed in Idaho.

Licensed in
ID
In the registry since
2021
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

403 S 11th St Ste 200
Boise, ID 83702-6968
Phone: (208) 342-3440
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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 · Licence D-5306 (ID)

Record details

NPI number1265002901
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorYes
NPI enumeratedJune 25, 2021
Last updated in NPPESSeptember 8, 2025
Certification dateSeptember 8, 2025
Mailing address403 S 11th St Ste 200, Boise, ID 83702-6968

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