DR. JOHN DAVID WALLACE DDS MD NPI 1811978349

NPI Information

  • NPI: 1811978349
  • Provider Name: DR. JOHN DAVID WALLACE, DDS, MD
  • Classification: Dentist - 1223S0112X
  • Specialization: Oral and Maxillofacial Surgery
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 8315 WALNUT HILL LN STE 120
    DALLAS, TX
    ZIP 75231
  • Phone: (214) 363-9946

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NPI Details

DR. John David Wallace, DDS, MD is an oral and maxillofacial surgery dentist in Dallas, TX. 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. John David Wallace, DDS, MD NPI is 1811978349. 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:

8315 WALNUT HILL LN STE 120
DALLAS, TX
ZIP 75231-218
Phone: (214) 363-9946
Fax: (214) 389-1953

The NPI 1811978349 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), Power Mobility Devices.

The enumeration date for this NPI number is 11/10/2005 and was last updated on 6/16/2023.

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
11223S0112XDentistOral and Maxillofacial Surgery19862TEXASYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11750242-02MEDICAIDTEXAS

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: 11/21/2025

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