Doctor profile · Federal record
Dr. Kelly Waggener, D.M.D
General Practice Dentistry · Santa Rosa, CA
- NPI 1629111604
- 19 yrs on file
- Female
- Group practice
- No sanctions
Practice & contact
- Primary practice
-
80 Doctors Park Dr
Santa Rosa, CA 954056615
(707) 544-1836
fax (707) 542-0617
Credentials & registration
- NPI registered
- February 2007 — 19 yrs on file
- Profile last updated
- July 8, 2007
- Specialty taxonomy
- 1223G0001X — NUCC code
- State license (1)
- California #48404
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1629111604. Last verified May 11, 2026.Open Payments
Industry payments received
All-time total
$31
Transactions
1
Manufacturers
1
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| Align Technology, INC. | 1 | $31.42 |
By nature of payment
Frequently asked questions
What is Dr. Kelly Waggener's medical specialty?
Dr. Kelly Waggener practices General Practice Dentistry in Santa Rosa, CA.
Where does Dr. Kelly Waggener practice?
Dr. Kelly Waggener practices at 80 Doctors Park Dr, Santa Rosa, CA 954056615. Office phone: 7075441836.
What is Dr. Kelly Waggener's NPI?
Dr. Kelly Waggener's National Provider Identifier (NPI) is 1629111604, issued by NPPES.