Dr. Kelly Johanna Waggener is a Santa Rosa, California based Dentist who is specialized in
General Practice Dentistry. She does not accept the Medicare-approved amount. Patients will be billed for the treatment. Active license number of Dr. Kelly Johanna Waggener is
48404 for General Practice Dentistry in California. Her current practice location is
80 Doctors Park Dr, Santa Rosa. Patients can reach her at
707-544-1836.
Dr. Kelly Johanna Waggener is the primary dental care provider for patients of all ages. She is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Profile:
Dr. Kelly Johanna Waggener speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
| Name: | Dr. Kelly Johanna Waggener |
| Specialization: | Dentist |
| Gender: | Female |
| Credentials: | D.M.D |
| Accepts Medicare Assignment: | No |
| Practice Address: | 80 Doctors Park Dr, Santa Rosa,
California, 95405-6615 |
| Phone: | 707-544-1836 |
| Fax: | 707-542-0617 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| NPI Number: | 1629111604 |
| NPI Enumeration Date: | 15 Feb, 2007 |
| NPI Last Update On: | 08 Jul, 2007 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Kelly Johanna Waggener are as mentioned below.
| License Number | Specialization | State | Status | |
| 48404 | General Practice Dentistry | California | Primary | |
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 80 Doctors Park Dr,
Santa Rosa, California |
| Zip: | 95405-6615 |
| Phone Number: | 707-544-1836 |
| Fax Number: | 707-542-0617 |
Patients can reach Dr. Kelly Johanna Waggener at
80 Doctors Park Dr, Santa Rosa, California or can
call to book an appointment on 707-544-1836.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.