Wallace Sigmon McLaurin

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

30.025891 Issued in OH

Practice address

222 Piedmont Ave
Cincinnati, OH 45219

Phone

(513) 475-8783

Fax

(513) 475-7698

NPI assigned

Mar 24, 2015

Last updated

Jul 16, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• University Surgical-Dental Associates, LLC

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Cincinnati, OH
  • NPI 1649241787
  Medicare reassignment NPD
• Eastgate Oral Surgery and Implants

  • Oral and Maxillofacial Surgery (Dentist)
  • Cincinnati, OH
  • NPI 1689479248
  NPD Authorized official

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

{
    "created_epoch": "1427155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1467846824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2830 VICTORY PKWY",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452061785",
            "telephone_number": "513-475-8783",
            "fax_number": "513-475-7698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 PIEDMONT AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45219",
            "telephone_number": "513-475-8783",
            "fax_number": "513-475-7698"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 Diamond D Lake Rd",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "MS",
            "postal_code": "390428567",
            "country_code": "US",
            "telephone_number": "601-259-6739",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "210 Diamond D Lake Rd",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "MS",
            "postal_code": "390428567",
            "country_code": "US",
            "telephone_number": "601-259-6739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCLAURIN",
        "first_name": "WALLACE",
        "middle_name": "SIGMON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-24",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "OH",
            "license": "30.025891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keegan F McLarney
• Allison McLaughlin, LPCC, LICDC
• Laura Elizabeth McLaughlin, MA, LPC
• Margaret Mary McLaughlin, RN
• Shannon Marie McLaughlin, MPT, NCS
• Ellen McLean, DPT
• Hailey McLean, MD
• Jacob Daniel McLean, DO
• Kelly Marie McLean, M.D.
• Stacie Lynn McLean, CNP

• Oral & Maxillofacial Surgery (D.M.D.) in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2019; 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.