Provider Demographics
NPI:1295622769
Name:WAGNER SANDERS, NATALIE LYNN (RDH)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:LYNN
Last Name:WAGNER SANDERS
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:LYNN
Other - Last Name:WAGNER-SANDERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RDH
Mailing Address - Street 1:6696 MAPLE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-3437
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11670 ATWOOD RD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-9522
Practice Address - Country:US
Practice Address - Phone:530-887-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16446124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist