DENNIS LEE WALLACE (NPI# 1396790986) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396790986 |
| Entity Type | Individual |
| Full Name | DENNIS LEE WALLACE |
| Credential | P.A. |
| Practice Address |
4100 Beecher Rd Suite A Flint MI 48532-3661 |
| Practice Telephone | 8103423800 |
| Practice Fax Number | 8103423784 |
| Mailing Telephone | 8103423800 |
| Mailing Fax Number | 8103423784 |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2010-08-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
5601002261 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699741777 | Dennis Jaye Wallace | Optometrist | 662 East Visalia Road, Farmersville, CA 93223 | 2006-02-27 |
| Street Address |
4100 BEECHER RD SUITE A |
| City | FLINT |
| State | MI |
| Zip Code | 48532-3661 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174523575 | Jack Lee Nettleton | Radiology | 4100 Beecher Rd, Suite A, Flint, MI 48532-3661 | 2005-07-28 |
| 1659850162 | Angela Marie Hanna | Nurse Practitioner | 4100 Beecher Rd, Flint, MI 48532-3661 | 2018-08-07 |
| 1902305295 | Jennifer Lynn Chandler | Nurse Practitioner | 4100 Beecher Rd, Flint, MI 48532-3661 | 2018-02-02 |
| 1790952059 | Kiran Devisetty | Radiology | 4100 Beecher Rd, Suite A, Flint, MI 48532-3661 | 2008-05-14 |
| 1144403205 | Erin Jessica Burke | Physician Assistant | 4100 Beecher Rd, Suite A, Flint, MI 48532-3605 | 2007-12-12 |
| 1932315124 | Sandeep S Grewal | Internal Medicine | 4100 Beecher Rd, Ste B, Flint, MI 48532-3661 | 2007-05-15 |
| 1093839060 | Hesham E Gayar, M.d., P.C. | Radiology | 4100 Beecher Rd, Suite A, Flint, MI 48532-3605 | 2007-03-16 |
| 1316972086 | Christian Hyde | Radiology | 4100 Beecher Rd, Flint, MI 48532-3661 | 2006-07-11 |
| 1538105564 | Singh & Arora Oncology Hematology P C | Internal Medicine | 4100 Beecher Rd, Ste B, Flint, MI 48532-3605 | 2006-06-20 |
| 1700823705 | David Stuart Eilender | Internal Medicine | 4100 Beecher Rd, Ste. B, Flint, MI 48532-3661 | 2006-05-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524859 | Amber Marie Lee | Physician Assistant | 2265 South Lindenroad, Suite A, Flint, MI 48532 | 2020-09-25 |
| 1639709496 | Tammara Kamei | Counselor | 2425 S.linden Rd, Suite D Unit 100, Flint, MI 48532 | 2020-01-21 |
| 1306481882 | Christine Rice | Case Manager/Care Coordinator | 3169 Beecher Road, Flint, MI 48532 | 2019-11-08 |
| 1780154336 | Sarah Marie Shaw | Case Manager/Care Coordinator | 2091 Professional Drive, Flint, MI 48532 | 2018-11-27 |
| 1215412093 | Adria D Haynes | Social Worker | G-4413 Corunna Rd., Flint, MI 48532 | 2018-09-27 |
| 1689159378 | Vip Smiles Dentistry, Pllc | Dentist | 1104 South Linden Rd, Building B, Suite 1, Flint, MI 48532 | 2018-09-27 |
| 1942794797 | Premier Eye Specialists Pllc | Ophthalmology | 1160 S Linden Rd, Bldg. 1 Ste. A, Flint, MI 48532 | 2018-06-15 |
| 1720587710 | Cassandra Socia | Dental Hygienist | G3222 Beecher Road, Flint, MI 48532 | 2018-02-06 |
| 1235660291 | Ashley L Boltjes | Massage Therapist | 3277 Beecher Rd, Flint, MI 48532 | 2017-03-22 |
| 1497202774 | Tyneshia Mcfarland | Home Health | 2104 Ridgecliffe Dr, Flint, MI 48532 | 2016-09-05 |
| Find all providers in zip 48532 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524859 | Amber Marie Lee | Physician Assistant | 2265 South Lindenroad, Suite A, Flint, MI 48532 | 2020-09-25 |
| 1992107684 | Benjamin James Busuito | Physician Assistant | 225 E 5th St Ste 300, Flint, MI 48502-1641 | 2014-09-24 |
| 1558632224 | Barbara Carol Steer | Physician Assistant | 1289 S Linden Rd Ste B, Flint, MI 48532-3499 | 2012-01-26 |
| 1992251995 | Joseph Galard IIi | Physician Assistant | 2700 Robert T Longway Blvd, Suite B, Flint, MI 48503-2190 | 2016-08-30 |
| 1366997520 | Margaret Hall Noger | Physician Assistant | 5494 S Dort Hwy, Flint, MI 48507-4483 | 2016-08-17 |
| 1427439900 | Natalia Migas | Physician Assistant | 1 Hurley Plz, Flint, MI 48503-5902 | 2015-06-10 |
| 1144620758 | Stephanie Ann Ventvrini | Physician Assistant | 2 Hurley Plaza, Suite 209, Flint, MI 48503 | 2014-09-02 |
| 1316359128 | Nathan Lee Arnold | Physician Assistant | 4466 W Bristol Rd, Flint, MI 48507-3170 | 2014-05-28 |
| 1467890491 | Jessica Joy Jefferies | Physician Assistant | 1 Hurley Plz, Flint, MI 48503-5902 | 2013-06-12 |
| 1447512819 | Gary Fannon | Physician Assistant | 1 Hurley Plz, Flint, MI 48503-5902 | 2012-06-12 |
| Find all providers in FLINT | ||||
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| 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.