MICHAEL P. WALLACE D.M.D., PC (NPI# 1275770513) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275770513 |
| Entity Type | Organization |
| Organization Name | MICHAEL P. WALLACE D.M.D., PC |
| Practice Address |
9225 Manchester Rd Suite 101 Saint Louis MO 63144-2640 |
| Practice Telephone | 3149680003 |
| Practice Fax Number | 3149680383 |
| Mailing Telephone | 3149680003 |
| Mailing Fax Number | 3149680383 |
| Enumeration Date | 2009-01-08 |
| Last Update Date | 2009-01-08 |
| Authorized Official Name | DR. MICHAEL PATRICK WALLACE (OWNER) |
| Authorized Official Telephone | 3149680003 |
| Authorized Official Credential | D.M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
13992 | MO | Dental Providers |
| Street Address |
9225 MANCHESTER RD SUITE 101 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63144-2640 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679585038 | Michael Patrick Wallace | Dentist | 9225 Manchester Rd, Suite 101, Saint Louis, MO 63144-2640 | 2006-08-13 |
| 1578723292 | Daniel Allan Dunbar | Dentist | 9225 Manchester Rd, Ste. 201, Saint Louis, MO 63144-2640 | 2008-06-16 |
| 1356401459 | Keith Fletcher Anderson | Dentist | 9225 Manchester Rd, Suite 202, Saint Louis, MO 63144-2640 | 2006-12-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730681214 | Patrick Kojima | Pharmacist | 1520 S. Brentwood Blvd, Saint Louis, MO 63144 | 2018-03-01 |
| 1104257385 | Karen Misty Thornton | Counselor | 1750 S Brentwood Blvd Ste 503, Saint Louis, MO 63144 | 2013-12-12 |
| 1386804433 | Lisa Marie Ross | Social Worker | 2025 S Brentwood, Suite 206, St Louis, MO 63144 | 2008-06-12 |
| 1568667665 | St. Joseph Institute for The Deaf | Speech-Language Pathologist | 1314 Strassner, Brentwood, MO 63144 | 2007-06-19 |
| 1720292030 | Albert A Barton | Social Worker | 2806 S Brentwood Blvdd, St Louis, MO 63144 | 2007-05-09 |
| 1083736243 | Gary Jean Jameson | Chiropractor | 2901 S Brentwood Blvd, St Louis, MO 63144 | 2007-04-06 |
| 1649340662 | Lindsay Michelle Ledbetter | Physical Therapist | 8228 Brentwood Industrial Drive, Brentwood, MO 63144 | 2006-11-08 |
| 1316041627 | Jandhyala Satya Sagar | Internal Medicine | 1400 Strassner Rd, Brentwood, MO 63144 | 2006-09-08 |
| 1396855326 | Jane E Loitman | Internal Medicine | 8044 Manchester Rd, Saint Louis, MO 63144 | 2006-08-31 |
| 1164532289 | Jayne M Scanlan | Physical Therapist | 2937 South Brentwood Blvd, Brentwood, MO 63144 | 2006-08-30 |
| Find all providers in zip 63144 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801493762 | Alexander Ahmadi | Dentist | 4171 Crescent Dr Ste 102, Saint Louis, MO 63129-3645 | 2020-10-05 |
| 1396353876 | Michael Rehme Jr. | Dentist | 2821 N Ballas Rd Ste 245, Saint Louis, MO 63131-2378 | 2020-07-21 |
| 1235771155 | James T Fetsch Dmd LLC | Dentist | 10004 Kennerly Rd Suite 240, Saint Louis, MO 63128 | 2019-10-11 |
| 1013579010 | Jasmine Esmailzadegan | Dentist | 200 S Kirkwood Rd Ste 90, Saint Louis, MO 63122-4351 | 2019-07-01 |
| 1194295964 | Rivka Goldenhersh, D.m.d., LLC | Dentist | 620a N Mcknight Rd Ste 2a, Saint Louis, MO 63132 | 2018-12-04 |
| 1952895252 | Feras Al Khatib | Dentist | 7809 Watson Rd, Saint Louis, MO 63119-5408 | 2018-06-20 |
| 1255825675 | Brenton Patrick Ruopp | Dentist | 16 Hampton Village Plz Ste 229, Saint Louis, MO 63109-2111 | 2018-06-19 |
| 1598258501 | Daniel Thomas Doherty | Dentist | 621 S New Ballas Rd # 10, Saint Louis, MO 63141-8232 | 2018-06-13 |
| 1649700964 | Adam J Bree | Dentist | 605 Old Ballas Rd Ste 118, Saint Louis, MO 63141-7070 | 2017-06-19 |
| 1811448863 | We Care Mobile Dental LLC | Dentist | 6903 Waterman Ave, Saint Louis, MO 63130-4333 | 2016-10-14 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63144 |
Please comment or provide details below to improve the information on MICHAEL P. WALLACE D.M.D., PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.