Mark Albert Waggonner, DDS

General Practice Dentistry · Sun City, CA

Individual Active NPI

NPI number 1578541355

Practice location

28401 Bradley Rd
Sun City, CA 92586-3040
Phone
(951) 679-6355
Fax
(951) 679-6355

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NPI record

NPI
1578541355
Entity type
Individual (Type 1)
Enumeration date
January 3, 2006
Last updated
July 13, 2026
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X 24189 CA

Mailing address

12020 Paradise St
Grand Terrace, CA 92313-5335
Phone
(909) 824-6251

About Dr. Waggonner

Mark Albert Waggonner, DDS is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 28401 Bradley Rd, Sun City, CA 92586-3040. The NPI number 1578541355 was assigned on January 3, 2006 and the record was last updated on July 13, 2026.

Dr. Waggonner lists a license in the registry: #24189 (CA) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Mark Albert Waggonner, DDS?

The NPI number is 1578541355.

What is the phone number of Dr. Waggonner?

The phone number listed for the practice location is (951) 679-6355.

Where is Dr. Waggonner located?

28401 Bradley Rd, Sun City, CA 92586-3040.

What is the taxonomy code for Dr. Waggonner?

The primary taxonomy code is 1223G0001X – General Practice Dentistry.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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