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DR. NEILSON LANE WAGLEY DMD NPI 1427582964


NPI Information

NPI: 1427582964
Provider Name: DR. NEILSON LANE WAGLEY, DMD
Classification: Dentist - 1223S0112X
Entity Type: Individual

Specialization: Oral and Maxillofacial Surgery

PECOS Registration: Yes

Address:
5437 MAHONING AVE
AUSTINTOWN, OH
ZIP 44515
Phone: (330) 792-2501
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DR. Neilson Lane Wagley, DMD is an oral and maxillofacial surgery dentist in Austintown, OH with 7 years of experience. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. DR. Neilson Lane Wagley, DMD NPI is 1427582964. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIV OF PITTSBURGH SCHOOL OF DENTAL MEDICINE
Graduation Year:2017

The provider's business location address is:

5437 MAHONING AVE
AUSTINTOWN, OH
ZIP 44515-437
Phone: (330) 792-2501

The NPI 1427582964 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/11/2017 and was last updated on 6/14/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1122300000XDentist11222TENNESSEENo
21223S0112XDentistOral and Maxillofacial Surgery30.026403OHIOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
130.026403OTHEROHIOSTATE DENTAL LICENSE
211222OTHERTENNESSEESTATE DENTAL LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.