=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962379800
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HUNTINGTOWN DENTAL AND SLEEP SOLUTIONS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/23/2025
-----------------------------------------------------
Last Update Date | 10/23/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1430 SOLOMONS ISLAND RD STE 3
-----------------------------------------------------
City | HUNTINGTOWN
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20639-8711
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-535-4022
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4020 OLD TOWN RD UNIT 339
-----------------------------------------------------
City | HUNTINGTOWN
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20639-7514
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-535-4022
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. SAMANTHA WAGLER
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 813-362-4978
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------