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DR. MARTHA COCHRAN WALLACE D.M.D. NPI 1639172158


NPI Information

NPI: 1639172158
Provider Name: DR. MARTHA COCHRAN WALLACE, D.M.D.
Classification: Dentist - 1223G0001X
Entity Type: Individual

Specialization: General Practice

Address:
1400 6TH AVE S
BIRMINGHAM, AL
ZIP 35233
Phone: (205) 930-1015
Get Directions

DR. Martha Cochran Wallace, D.M.D. is a general practice dentist in Birmingham, AL. The provider is 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. DR. Martha Cochran Wallace, D.M.D. NPI is 1639172158. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1400 6TH AVE S
BIRMINGHAM, AL
ZIP 35233-502
Phone: (205) 930-1015
Fax: (205) 930-1448

The enumeration date for this NPI number is 5/30/2005 and was last updated on 1/5/2011.


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
11223G0001XDentistGeneral Practice3030ALABAMAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1510-40458OTHERALABAMABLUE CROSS BLUE SHIELD
2103676MEDICAIDALABAMA
3103578MEDICAIDALABAMA
4103678MEDICAIDALABAMA
5103546MEDICAIDALABAMA
6510-40460OTHERALABAMABLUE CROSS BLUE SHIELD
71639172158MEDICAIDALABAMA
8510-40459OTHERALABAMABLUE CROSS BLUE SHIELD
9510-40457OTHERALABAMABLUE CROSS BLUE SHIELD

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: 11/14/2023

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