Cayce Wallace, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

D009147 Issued in AZ

Practice address

5717 E. Thomas Road
Ste 110
Scottsdale, AZ 85251

Phone

(480) 207-5070

Fax

(480) 304-3005

NPI assigned

Sep 10, 2010

Last updated

Jun 28, 2018By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Flagstaff Dentistry 4 Kids, PLLC

  dba Flagstaff Dentistry 4 Kids

  • General Practice Dentistry
  • Flagstaff, AZ
  • NPI 1427411255
  NPD (past)
• E. P. Dentistry 4 Kids, PLLC

  dba E.P. Dentistry 4 Kids

  • General Practice Dentistry
  • El Paso, TX
  • NPI 1669624656
  NPD (past)

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

{
    "created_epoch": "1284076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1477860526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8151 E INDIAN BEND RD",
            "address_2": "#111",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852504826",
            "telephone_number": "480-607-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5717 E. THOMAS ROAD",
            "address_2": "STE 110",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "85251",
            "telephone_number": "480-207-5070",
            "fax_number": "480-304-3005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9813 Dyer St",
            "address_2": "ste 100",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799244793",
            "country_code": "US",
            "telephone_number": "915-855-4442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "CAYCE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-10",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "0025851",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AZ",
            "license": "D009147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanne U Wall, MSW, LCSW
• Thomas J Wall, MD
• Alex Wallace, M.D.
• Amanda Kay Wallace
• Andrew Nels Wallace, D.O.
• Jamie Russelle Wallace, MD
• Lauren Wallace
• Logan Wallace, LCSW
• Loran Paige Wallace, LPC
• Mark Randall Wallace, MD

• Pediatric Dentistry in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Pediatric Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2018; 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.