Leslie H Wallace, DR

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8882 Issued in TN

Practice address

Naval Hospital
Santa Margarita Road
Camp Pendleton, CA 92055

Phone

(760) 725-8882

Fax

(760) 725-8882

NPI assigned

Nov 11, 2008

Last updated

Nov 11, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1226361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226361600000",
    "number": "1114171667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2360 PASEO DE LAURA UNIT 63",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920563721",
            "telephone_number": "760-725-1200",
            "fax_number": "760-725-1267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVAL HOSPITAL",
            "address_2": "SANTA MARGARITA ROAD",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "92055",
            "telephone_number": "760-725-8882",
            "fax_number": "760-725-8882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "LESLIE",
        "middle_name": "H",
        "credential": "DR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-11",
        "last_updated": "2008-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "8882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debbie Elizabeth Walker, LDH, RDH, BSC
• Jordan R Walker, SOIDC
• Travis Michael Walker, SOIDC
• Robert Seth Wall, M.D.
• Ryan Egan Wall, M.D.
• Amanda E Wardleigh, IDC
• Dorothea Elizabeth Ware, LCSW
• Andrew Owen Warner, SOIDC
• Ryan Thomas Warner, D.O.
• Joshua Watersjackson, ATC

• General Practice Dentistry in Camp Pendleton, CA
• Providers in Camp Pendleton, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.