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DR. JEFFREY SAMUEL WALLIS D.M.D. NPI 1528371507


NPI Information

NPI: 1528371507
Provider Name: DR. JEFFREY SAMUEL WALLIS, D.M.D.
Classification: Dentist - 1223S0112X
Entity Type: Individual

Specialization: Oral and Maxillofacial Surgery

PECOS Registration: Yes

Address:
17 W ORMOND AVE
CHERRY HILL, NJ
ZIP 08002
Phone: (856) 428-4445
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DR. Jeffrey Samuel Wallis, D.M.D. is an oral and maxillofacial surgery dentist in Cherry Hill, NJ with 15 years of experience. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. DR. Jeffrey Samuel Wallis, D.M.D. NPI is 1528371507. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

17 W ORMOND AVE
CHERRY HILL, NJ
ZIP 08002-041
Phone: (856) 428-4445
Fax: (856) 428-4497

The NPI 1528371507 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Removal of growth of mouth (HCPCS:40812)
  • X-ray imaging of teeth (HCPCS:70355)

The enumeration date for this NPI number is 7/20/2010 and was last updated on 10/30/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223S0112XDentistOral and Maxillofacial SurgeryDS038160PENNSYLVANIANo
21223S0112XDentistOral and Maxillofacial Surgery22DI02571300NEW JERSEYYes
31223S0112XDentistOral and Maxillofacial Surgery22DI02571301NEW JERSEYNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.