DR. KATHERINE AHN WALLACE D.D.S. NPI 1790843381

NPI Information

  • NPI: 1790843381
  • Provider Name: DR. KATHERINE AHN WALLACE, D.D.S.
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 11121 LOS ALAMITOS BLVD STE 201
    LOS ALAMITOS, CA
    ZIP 90720
  • Phone: (714) 230-2434

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NPI Details

DR. Katherine Ahn Wallace, D.D.S. is a general practice dentist in Los Alamitos, CA. 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. Katherine Ahn Wallace, D.D.S. NPI is 1790843381. 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:

11121 LOS ALAMITOS BLVD STE 201
LOS ALAMITOS, CA
ZIP 90720-603
Phone: (714) 230-2434

The NPI 1790843381 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 enumeration date for this NPI number is 12/5/2006 and was last updated on 7/23/2021.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1122300000XDentist41055CALIFORNIANo
21223G0001XDentistGeneral Practice41055CALIFORNIAYes
31223P0221XDentistPediatric Dentistry41055CALIFORNIANo

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: 3/30/2025

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