David Allen Wallace, DDS, MS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

1880 Issued in WV

Practice address

206 S Walker St
Princeton, WV 24740-2747

Phone

(304) 425-2611

NPI assigned

Aug 11, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Interoperability endpoints

• Direct secure messaging: dwalla08@yourcarecommunity.org

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1386646206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 S WALKER ST",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402747",
            "telephone_number": "304-425-2611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 S WALKER ST",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402747",
            "telephone_number": "304-425-2611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "DAVID",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WV",
            "license": "1880",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "VA",
            "license": "0401003440",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "800476",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0138333000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany Walker
• Debra Walker
• Mary Walker
• Robert Walker, MD
• Katheryn Wall
• Kimberly Waller
• Jennifer Lynn Walls
• Bonnie Walters
• Chance Walters
• James Walters III

• Oral and Maxillofacial Surgery (Dentist) in Princeton, WV
• Providers in Princeton, WV by specialty
• Oral and Maxillofacial Surgery (Dentist) in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.