Caroline Wallace, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401007934 Issued in VA

Practice address

103 S Colorado St
Salem, VA 24153-3848

Phone

(540) 387-3844

Fax

(540) 387-3845

NPI assigned

Mar 11, 2014

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

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Caroline Wallace DDS

  • Dentist
  • Salem, VA
  • NPI 1295819738
  NPD (past) Authorized official

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

{
    "created_epoch": "1394496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394496000000",
    "number": "1134545494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 S COLORADO ST",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241533848",
            "telephone_number": "540-387-3844",
            "fax_number": "540-387-3845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 S COLORADO ST",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241533848",
            "telephone_number": "540-387-3844",
            "fax_number": "540-387-3845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "CAROLINE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-11",
        "last_updated": "2014-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401007934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Lorie Walker
• Shanique L Walker, BEHAVIOR TECHNICIAN
• Wall Therapeutic Solutions, LLC
• Mikayla Wall
• Robert Edward Wallace, DDS
• Sadie Wallace
• Ward Transitional Services Inc
• Melissa Ward
• Tracey Ward, LCSW, ACM-SW, CCM

• General Practice Dentistry in Salem, VA
• Providers in Salem, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.