Dr. Russell Kent Wangen , DMD
Dentist - General Practice • Pawnee, IL
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. Russell Wangen has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Dr. Russell Wangen, DMD was a registered Dentist - General Practice practicing in Pawnee, IL. Throughout an active medical career spanning 17 years, Dr. Wangen provided care at the practice location at 1105 CARROLL ST. until profile deactivation on 2023-11-29.
Practice Location & Contact Primary Location
1105 Carroll St.
Pawnee, IL 65558
Specialty Benchmarks & Practice Insights
Comparative analytics for Dentist - General Practice in Pawnee, IL
Practicing in Pawnee, IL (5581 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 1223G0001X
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.
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on November 29, 2023
NPI status registered as active in NPPES database
Registered at 1105 CARROLL ST., PAWNEE, IL 65558 (Tel: 2176257953)
Registered at 1105 CARROLL ST., PO BOX 860, PAWNEE, IL 65558 (Tel: 2176257953)
Recorded as RUSSELL WANGEN, DMD
Dentist (License #1915698 in IL)
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
1105 Carroll St., Po Box 860
Pawnee, IL 65558
Phone: 2176257953
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