DR. MARTHA COCHRAN WALLACE (NPI# 1639172158) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1639172158 |
Entity Type | Individual |
Full Name | DR. MARTHA COCHRAN WALLACE |
Credential | D.M.D. |
Practice Address |
1400 6th Ave S Birmingham AL 35233-1502 |
Practice Telephone | 2059301015 |
Practice Fax Number | 2059301448 |
Mailing Telephone | 2059301015 |
Mailing Fax Number | 2059301448 |
Enumeration Date | 2005-05-30 |
Last Update Date | 2011-01-05 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223G0001X |
Dentist Specialization: General Practice |
3030 | AL | Dental Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AL | BLUE CROSS BLUE SHIELD | 510-40457 | 01 |
AL | BLUE CROSS BLUE SHIELD | 510-40458 | 01 |
AL | BLUE CROSS BLUE SHIELD | 510-40459 | 01 |
AL | BLUE CROSS BLUE SHIELD | 510-40460 | 01 |
AL | 103676 | 05 | |
AL | 1639172158 | 05 | |
AL | 103546 | 05 | |
AL | 103578 | 05 | |
AL | 103678 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356481113 | Martha C. Wallace | Audiologist | 2101 N Midland Dr, Suite 4, Midland, TX 79707-5507 | 2007-02-08 |
1073695722 | Martha E Wallace | Physical Therapist | 4343 N Josey Ln, Carrollton, TX 75010-4603 | 2006-10-20 |
Street Address |
1400 6TH AVE S |
City | BIRMINGHAM |
State | AL |
Zip Code | 35233-1502 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770108599 | Janie Charleston Clay | Dietitian, Registered | 1400 6th Ave S, Birmingham, AL 35233-1502 | 2020-06-09 |
1770124091 | Sybil Rochelle Hagler | Nurse Practitioner | 1400 6th Ave S, Birmingham, AL 35233-1502 | 2019-10-08 |
1912553470 | Morgan Massey | Dietitian, Registered | 1400 6th Ave S, Birmingham, AL 35233-1502 | 2019-08-12 |
1700343662 | Hayden Hulgan | Dietitian, Registered | 1400 6th Ave S, Birmingham, AL 35233-1502 | 2019-02-27 |
1013484278 | Rebecca Elizabeth Smith | Nurse Practitioner | 1400 6th Ave S, Birmingham, AL 35233-1502 | 2018-10-25 |
1023584208 | Lindsay Quinn Adler | Dietitian, Registered | 1400 6th Ave S, Birmingham, AL 35233-1502 | 2018-10-16 |
1881160067 | Lacey Gammon | Dietitian, Registered | 1400 6th Ave S, Birmingham, AL 35233-1502 | 2018-10-16 |
1417423690 | Elizabeth Koepsel | Dietitian, Registered | 1400 6th Ave S, Birmingham, AL 35233-1502 | 2018-10-16 |
1871069054 | Melanie Jones Hildebrandt | Dietitian, Registered | 1400 6th Ave S, Birmingham, AL 35233-1502 | 2018-10-16 |
1417423609 | Janet Kerschner Bedsole | Dietitian, Registered | 1400 6th Ave S, Birmingham, AL 35233-1502 | 2018-10-16 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821605700 | Motivity Chiropractic | Chiropractor | 2413 2nd Avenue South, Ste 100, Birmingham, AL 35233 | 2020-09-25 |
1477164580 | Rebecca Diane Davis | Physician Assistant | 701 S. 19th St, Lhr 112, Birmingham, AL 35233 | 2020-08-12 |
1972136794 | Faleh Ali Alshanhrani | Student in an Organized Health Care Education/Training Program | Children's of Alabama, 1600 7th Ave South, Birmingham, AL 35233 | 2020-02-20 |
1972149128 | Jessica Lynne Miller | Registered Nurse | 1816 6th Ave South, Birmingham, AL 35233 | 2019-11-22 |
1881156404 | Chalandra Barley | Registered Nurse | 1802 6th Ave S., 7th Floor Sicu, Birmingham, AL 35233 | 2019-04-02 |
1255893004 | Mia Weitman Neustein | Registered Nurse | Uab Wic -- Gynx, 1700 6th Avenue South, Birmingham, AL 35233 | 2019-04-02 |
1457813214 | Tabrisha Love | Registered Nurse | Uab University Hospital 1802 6th Ave S, Birmingham, AL 35233 | 2019-04-02 |
1356809602 | Catherine Mary Verga | Occupational Therapist | 1600 7th Ave. S., Mcwane Building Pt/ot Department, Birmingham, AL 35233 | 2019-03-06 |
1649736752 | Proton International Alabama, LLC | Clinic/Center | 400 20th Street South, Birmingham, AL 35233 | 2019-02-13 |
1447728910 | Eric Jackson | Specialist/Technologist | 1219 6th Ave S, Birmingham, AL 35233 | 2018-11-02 |
Find all providers in zip 35233 |
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 |
---|---|---|---|---|
1134739246 | Alabama Dental Professionals, P.C. | Dentist | 1200 20th St S Ste 202, Birmingham, AL 35205-3859 | 2020-08-04 |
1396361341 | Noopur Shah | Dentist | 727 Stoneriver Dr, Birmingham, AL 35211-4560 | 2020-06-24 |
1396366134 | Daniel Arthur Petersen | Dentist | 3350 Altamont Rd S Apt B12, Birmingham, AL 35205-2192 | 2020-05-04 |
1437790722 | Heath Bryan Coleman, Dds of Alabama, LLC | Dentist | 5024 Pinnacle Sq Ste 116, Birmingham, AL 35235-3176 | 2019-10-08 |
1295393106 | Ac Dentistry | Dentist | 7350 Cahaba Valley Rd Ste 106, Birmingham, AL 35242-6318 | 2019-06-05 |
1356818462 | Sergio Daniel Loubriel | Dentist | 1908 Springfield Loop W, Birmingham, AL 35242-5130 | 2018-10-26 |
1528577129 | Genesis Dental Group Homewood P.C. | Dentist | 2045 Brookwood Medical Ctr Dr Ste 4, Birmingham, AL 35209-6809 | 2017-09-26 |
1124565676 | Dentistry for Awesome Kids | Dentist | 623 8th Ave W, Birmingham, AL 35204-3604 | 2017-01-23 |
1306291711 | Melissa Santos Perez | Dentist | 1820 Gadsden Hwy Ste 112, Birmingham, AL 35235 | 2016-05-04 |
1326434671 | M. Austin Boyd Dmd PC | Dentist | 5891 Valley Rd, Birmingham, AL 35235-8693 | 2015-04-14 |
Find all providers in BIRMINGHAM |
City | BIRMINGHAM |
Zip Code | 35233 |
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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.