WALLACE WAYNE HANCOCK (NPI# 1598828840) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598828840 |
| Entity Type | Individual |
| Full Name | WALLACE WAYNE HANCOCK |
| Credential | DDS |
| Practice Address |
1900 Pennsylvania Ave Fairfield CA 94533-3690 |
| Practice Telephone | 7074271026 |
| Mailing Telephone | 7074271026 |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 19504 | CA | Dental Providers |
| Street Address |
1900 PENNSYLVANIA AVE |
| City | FAIRFIELD |
| State | CA |
| Zip Code | 94533-3690 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386706273 | Megha Raja Jadhav | Dentist | 1900 Pennsylvania Ave, B2, Fairfield, CA 94533-3690 | 2006-12-15 |
| 1205125242 | Justin Burton Jergensen | Dentist | 1900 Pennsylvania Ave, Fairfield, CA 94533-3690 | 2011-03-30 |
| 1063626505 | Willard Emery Zurcher | Dentist | 1900 Pennsylvania Ave, Fairfield, CA 94533 | 2007-05-10 |
| 1225164460 | Zahra Modaressi | Dentist | 1900 Pennsylvania Ave, Suite B-2, Fairfield, CA 94533-3690 | 2007-02-23 |
| 1215086335 | John M Lewis | Dentist | 1900 Pennsylvania Ave, Fairfield, CA 94533-3690 | 2007-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609487347 | Shayondelice Sledge | Case Manager/Care Coordinator | 3001 N. Texas St., #27, Fairfield, CA 94533 | 2020-08-16 |
| 1508401191 | Tiffany Ann Garcia | Social Worker | 1301 Roman Way, Martinez, CA 94533 | 2019-11-07 |
| 1609424175 | Andrew Stephens | Student in an Organized Health Care Education/Training Program | Dgmc, 101 Bodin Cir, Fairfield, CA 94533 | 2019-08-28 |
| 1821645383 | Michelle Marie Hackett | Marriage & Family Therapist | 1745 Enterprise Dr., Bldg. 2, Ste 1a, Fairfield, CA 94533 | 2019-08-20 |
| 1780154369 | Maria Leonila Ramos Corpuz | Behavior Technician | 744 Empire Street Suite 160, Fairfield, CA 94533 | 2018-11-27 |
| 1629575303 | Jeanne Ann Kiernan | Dentist | 690 Airman Dr, Apo, AA 94533 | 2018-04-10 |
| 1629596820 | Max Kardos | Student in an Organized Health Care Education/Training Program | 801 Empire St., Fairfield, CA 94533 | 2017-09-07 |
| 1780119867 | Justin Denhart Dickson | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir Fairfield Ca 94533, David Grant Medical Center, Fpo, AA 94533 | 2017-04-26 |
| 1639613409 | Behrooz Shafiezadeh | Marriage & Family Therapist | Caminar, 601 Madison Street, Suite D, Fairfield, CA 94533 | 2016-12-13 |
| 1427500164 | Tanya Ayers | Counselor | 801 Empire Street, Fairfield, CA 94533 | 2016-10-28 |
| Find all providers in zip 94533 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760045066 | Stephen Miguel Pou | Dentist | 2150 Black Rock Tpke Ste 201, Fairfield, CT 06825 | 2019-04-22 |
| 1093282923 | Valle Smiles | Dentist | 1955 W Texas St Ste 12, Fairfield, CA 94533-4462 | 2018-10-29 |
| 1437658614 | S.y.y Jang Dds Corp | Dentist | 1955 W Texas St Ste 2c, Fairfield, CA 94533-4462 | 2018-02-02 |
| 1104347384 | Avanthi Tiruvadi | Dentist | 1700 Post Rd Ste A, Fairfield, CT 06824-5795 | 2017-06-28 |
| 1659823110 | Neal Merchant | Dentist | 2801 Waterman Blvd Ste 120, Fairfield, CA 94534-2987 | 2016-11-01 |
| 1346625407 | Bernadette Tesorero Ancheta | Dentist | 1555 Webster St, Suite B, Fairfield, CA 94533-4999 | 2015-07-29 |
| 1033521299 | Wendy Wang Austin | Dentist | 2226 Black Rock Tpke Ste 1, Fairfield, CT 06825-3240 | 2014-05-22 |
| 1306275482 | Steve Halili Galvan | Dentist | 1500 Oliver Rd, Ste. F, Fairfield, CA 94534-3450 | 2013-11-08 |
| 1568890838 | Gill and Lambridis Dental Corporation | Dentist | 3332 N Texas St Ste 5c, Fairfield, CA 94533-9758 | 2013-10-24 |
| 1578990099 | Navid Mehranpour | Dentist | 1545 N Texas St Ste 311, Fairfield, CA 94533-5623 | 2013-09-29 |
| Find all providers in FAIRFIELD | ||||
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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.