NPIMap

Organization Active NPI

John D. Wallace, DDS, MD, PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Dallas, TX
National Provider Identifier
1356535314
Registry record updated Jun 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
19862 Issued in TX
Legal business name
JOHN D. WALLACE, DDS, MD, PA
Doing business as
Dallas Oral Surgery Associates
Practice address
8315 Walnut Hill LN Ste 120
Dallas, TX 75231-4218
Phone
(214) 363-9946
Fax
(214) 389-1953
NPI assigned
Sep 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2023

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

Authorized official

Name
John D Wallace, DDS, MDNPI 1811978349
Title
Doctor
Phone
(214) 334-7722

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X 19862 TX Primary

Addresses

Primary practice location

8315 Walnut Hill LN Ste 120
Dallas, TX 75231-4218

Mailing address

8315 Walnut Hill LN
Suite 120
Dallas, TX 75231-4218
Phone (214) 363-9946

Other names 1

  • Dallas Oral Surgery Associates Doing business as

National Provider Directory

National Provider Directory

Locations

8315 Walnut Hill Ln
Ste 120
Dallas, TX 75231
Phone (214) 363-9946

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686873600000",
    "number": "1356535314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8315 WALNUT HILL LN",
            "address_2": "SUITE 120",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314218",
            "telephone_number": "214-363-9946",
            "fax_number": "214-389-1953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8315 WALNUT HILL LN STE 120",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314218",
            "telephone_number": "214-363-9946",
            "fax_number": "214-389-1953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN D. WALLACE, DDS, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-04",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "214-334-7722",
        "authorized_official_credential": "DDS, MD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "19862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dallas Oral Surgery Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dallas Oral Surgery Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2023; 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.