Donald McQuire Wallace, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

0401004509 Issued in VA

Practice address

3700 Old Forest Rd
Lynchburg, VA 24501-6900

Phone

(434) 385-9454

Fax

(434) 385-7681

NPI assigned

Mar 5, 2007

Sex

Male

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": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299110400000",
    "number": "1295864304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 OLD FOREST RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245016900",
            "telephone_number": "434-385-9454",
            "fax_number": "434-385-7681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 OLD FOREST RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245016900",
            "telephone_number": "434-385-9454",
            "fax_number": "434-385-7681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "DONALD",
        "middle_name": "MCQUIRE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2011-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401004509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren A. Walker, CRNA
• Lloyd Henry Walker, PA
• Johnathan Walkine
• Joseph Charles Preston Wall, LPC
• Deaven McGuire Wallace, MA, LPC
• Kojo Wallace, MD
• William Miles Wallace
• Brenda Sue Waller, M.D.
• Sandra Waller, CERTIFIED HAIR LOSS
• John Wallman, PT

• Dentist in Lynchburg, VA
• Providers in Lynchburg, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2011; 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.