Individual provider · Type 1 NPI
Jennah Castleman Wagner, DMD
Periodontics · Annapolis, MD
NPI number
1245759976
Active
Practice location
104 Forbes St Ste 204
Annapolis, MD 21401-1598
Mailing address
8143 Ridgely Loop
Severn, MD 21144-2835
Other practice locations
- 20 Crossroads Dr Ste 110, Owings Mills, MD 21117-5480 · (410) 363-2500
- 2600 Longstone Ln Ste 101, Marriottsville, MD 21104-1530 · (410) 442-0103
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Periodontics | 1223P0300X | 33499 (TX) |
| Periodontics Primary | 1223P0300X | 18973 (MD) |
| Dentist | 122300000X | 33499 (TX) |
Periodontics: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
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- Robert A. Bouffard, DENTISTPeriodontics Annapolis, MD NPI 1730150905
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About NPI 1245759976
Jennah Castleman Wagner, DMD's National Provider Identifier is 1245759976, issued on Sep 13, 2017. The primary taxonomy on file is Periodontics (1223P0300X), and the practice location is in Annapolis, MD. The record was last updated on Jan 20, 2026.