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Deactivated NPI 1750349171 Deactivated / Inactive NPI Male Practitioner

Dr. Robert Karl Waggener , DDS

Dentist - General Practice • Pueblo, CO

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Robert Waggener has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 03, 2006
NPI Deactivation Date August 02, 2023
Total Practice Duration ~17 Years of Practice (2006 – 2023)

Professional Overview & Biography Verified Profile Summary

Dr. Robert Waggener, DDS was a registered Dentist - General Practice practicing in Pueblo, CO. Throughout an active medical career spanning 17 years, Dr. Waggener provided care at the practice location at 4112 OUTLOOK BLVD until profile deactivation on 2023-08-02.

Practice Location & Contact Primary Location

Practice Address

4112 Outlook Blvd

Pueblo, CO 810081667

Telephone 7195531065
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Pueblo, CO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 18.5 Yrs
Regional Practice Density
67 Specialists

Practicing in Pueblo, CO (2613 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License CO 104577

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Dr. Karen Bishop , DPT

Physical Therapist

NPI 1003295346

Doctor of Physical Therapy

Pamela Kubly , CPNP

Nurse Practitioner - Pediatrics

NPI 1053350496

Certified Pediatric Nurse Practitioner

Kathy Young

Occupational Therapist

NPI 1053588368
NPI 1083881536

Physical Therapist

Dr. Alex Romero , MD

Orthopaedic Surgery

NPI 1124220595

Doctor of Medicine (M.D.)

Dr. Rita Friedrichs , MD

Internal Medicine

NPI 1134199680

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated August 02, 2023

Record deactivated on August 02, 2023

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 4112 OUTLOOK BLVD, PUEBLO, CO 810081667 (Tel: 7195531065)

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Updated Business Mailing Address July 08, 2007

Registered at 12 ERICA CT, PUEBLO, CO 810011074 (Tel: 7195442030)

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Provider Name / Credentials Updated July 08, 2007

Recorded as ROBERT WAGGENER, DDS

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #104577 in CO)

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Initial NPI Registration & Enumeration May 03, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1750349171
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 03, 2006
Last Update: July 08, 2007
Deactivation Date: August 02, 2023

Mailing Address

12 Erica Ct

Pueblo, CO 810011074

Phone: 7195442030

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.