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

Dr. Kevin Joseph Wagner, DMD

Individual provider Dentist · NPI 1558094508

Dr. Kevin Joseph Wagner, DMD is a Dentist in Pocatello, Idaho. Licensed in Idaho. Registered with an NPI since 2022.

Licensed in
ID
In the registry since
2022
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

See every abbreviation used in this directory →

Practice location Address checks out

921 S 8th Ave Stop 8088
Pocatello, ID 83201
Phone: (609) 923-0168
Show map & directions

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

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence D-5422 (ID)

Record details

NPI number1558094508
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorNo
NPI enumeratedJuly 7, 2022
Last updated in NPPESJuly 7, 2022
Certification dateJune 27, 2022

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