Deborah S Wallace, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS3823 Issued in TN

Practice address

445 Highway 79
Dover, TN 37058-6941

Phone

(931) 232-8287

Fax

(931) 232-2310

NPI assigned

Nov 30, 2006

Sex

Female

Sole proprietor

Yes

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": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124195359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 HIGHWAY 79",
            "address_2": "P. O. BOX 435",
            "city": "DOVER",
            "state": "TN",
            "postal_code": "370586941",
            "telephone_number": "931-232-8287",
            "fax_number": "931-232-2310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 HIGHWAY 79",
            "city": "DOVER",
            "state": "TN",
            "postal_code": "370586941",
            "telephone_number": "931-232-8287",
            "fax_number": "931-232-2310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "DEBORAH",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS3823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tennessee Department of Health
• Lorraine H Tseng, D.D.S.
• Kimberly Faye Turner, R.N.
• Debra L Van Toor, NP
• David Gene Wallace, D.PH.
• Michelle Weisner, COTA
• Heather Trudeau Williams, FNP
• Jennifer Williams, RN, IBCLC

• General Practice Dentistry in Dover, TN
• Providers in Dover, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.