C.M. WALLACE (NPI# 1487085072) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487085072 |
| Entity Type | Individual |
| Full Name | C.M. WALLACE |
| Other Name | CHARLES MACON WALLACE |
| Credential | DDS |
| Practice Address |
8951 Bonita Beach Rd Se Ste 206 Bonita Springs FL 34135-4202 |
| Practice Telephone | 2399928555 |
| Practice Fax Number | 2399928644 |
| Mailing Telephone | 2399928555 |
| Mailing Fax Number | 2399928644 |
| Enumeration Date | 2013-12-06 |
| Last Update Date | 2013-12-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DN14024 | FL | Dental Providers |
| Street Address |
8951 BONITA BEACH RD SE STE 206 |
| City | BONITA SPRINGS |
| State | FL |
| Zip Code | 34135-4202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427512540 | Bonita Wellness Center | Dentist | 8951 Bonita Beach Rd Se Ste 206, Bonita Springs, FL 34135-4202 | 2019-01-23 |
| 1508243932 | Shirley Marquez | Dentist | 8951 Bonita Beach Rd Se Ste 206, Bonita Springs, FL 34135-4202 | 2015-05-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063022051 | Td Dental Group LLC | Clinic/Center | 28410 Crossing Blvd, Suit 230, Bonita Springs, FL 34135 | 2020-08-04 |
| 1619591096 | Lucinda Zagnoli | Counselor | 3501 Health Center Blvd Suite 2140, Bonita Springs, FL 34135 | 2020-06-02 |
| 1124649512 | Samantha S Wadas | Occupational Therapist | Solaris Rehab, LLC, 9520 Bonita Beach Rd Se, Bonita Springs, FL 34135 | 2020-04-27 |
| 1245710409 | Carrie Silverman | Hearing Instrument Specialist | 8951 Bonita Beach Rd Se Ste 240, Bonita Springs, FL 34135 | 2018-08-17 |
| 1124513593 | Lee Memorial Health System | Pharmacy | 23450 Via Coconut Point, Estero, FL 34135 | 2018-06-27 |
| 1801303540 | Lee Tasha Perez | Acupuncturist | 8840 Terrene Ct Ste 101, Bonita Springs, FL 34135 | 2018-01-03 |
| 1164942686 | Mind/mood Counseling & Coaching Centers of Swfl, Pllc | Community/Behavioral Health | 9990 Coconut Road, Attn. Emily - Bes Manager, Bonita Springs, FL 34135 | 2017-06-26 |
| 1699295691 | Alfa Brothers Group | Durable Medical Equipment & Medical Supplies | 28161 Pine Haven Way, Apt 135, Bonita Springs, FL 34135 | 2017-06-21 |
| 1992257919 | Lillian Mary Catherine Lienhardt | Physician Assistant | 27390 Tennesse Street, Bonita Springs, FL 34135 | 2016-10-25 |
| 1104277623 | American Spine & Orthopeadic Institute, LLC | Orthopaedic Surgery | 3501 Health Center Blvd Ste 2430, Bonita Springs, FL 34135 | 2016-06-27 |
| Find all providers in zip 34135 | ||||
| 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 |
|---|---|---|---|---|
| 1346867850 | Anastasia Talalenko | Dentist | 27241 Bay Landing Dr Ste 13, Bonita Springs, FL 34135-4334 | 2020-06-30 |
| 1801323548 | Comfortable Care Dental Health Professionals, P.a. | Dentist | 24940 S Tamiami Trl Ste 202, Bonita Springs, FL 34134-7824 | 2017-05-12 |
| 1114330586 | Luis Fonseca | Dentist | 28441 S Tamiami Trl, Bonita Springs, FL 34134-3212 | 2014-06-03 |
| 1992915193 | Burton P Golumbic | Dentist | 3376 Woods Edge Cir, Suite 101, Bonita Springs, FL 34134-3435 | 2007-05-23 |
| 1467664128 | Gary Michael Stevens | Dentist | 26 8th Street, Bonita Springs, FL 34134-7453 | 2007-05-04 |
| 1508088048 | Comfortable Care Dental Health Professionals, Pa | Dentist | 16565 Vanderbilt Drive, Suite 2, Bonita Springs, FL 34134 | 2007-05-03 |
| 1306068044 | Garth B. Mccaffrey Dds Pa | Dentist | 8899 Timberwilde Dr Ste 1, Bonita Springs, FL 34135-7896 | 2007-05-03 |
| 1386865285 | Ann M Mihalko | Dentist | 25000 Bernwood Dr, Bonita Springs, FL 34135-7900 | 2007-05-01 |
| 1275750473 | Frederick Joseph Eck | Dentist | 8951 Bonita Beach Rd Se Ste 110, Bonita Springs, FL 34135-4202 | 2007-04-19 |
| 1487870929 | Craig Ashton | Dentist | 27544 Bayshore Dr, Bonita Springs, FL 34134-4057 | 2007-04-17 |
| Find all providers in BONITA SPRINGS | ||||
| City | BONITA SPRINGS |
| Zip Code | 34135 |
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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.