Zachary D Wallace, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4241 Issued in AR

Practice address

127 W Industrial Park Rd
Harrison, AR 72601

Phone

(870) 741-2808

NPI assigned

Apr 3, 2017

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

Locations

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

• Zachary D. Wallace, DDS, PLLC

  • Dental Clinic/Center
  • Harrison, AR
  • NPI 1144706581
  NPD Authorized official
• Stephen a. Beeler, D.D.S., P.a.

  • General Practice Dentistry
  • Harrison, AR
  • NPI 1225042286
  NPD (past)

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

{
    "created_epoch": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1497287817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 W INDUSTRIAL PARK RD",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726012205",
            "telephone_number": "417-209-0972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 W INDUSTRIAL PARK RD",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "72601",
            "telephone_number": "870-741-2808"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 N State St",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392164500",
            "country_code": "US",
            "telephone_number": "601-984-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "ZACHARY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-03",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "4241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaime Walden
• Walgreen Co
• Jordan Paxton Walker, LAC
• Rollie S Walker, APRN
• Cierra Wall
• Janice Renea Wallis
• Walmart Inc.
• Walmart Inc.
• Renee S Walsh, LCSW
• Chris Walter, MHPP

• General Practice Dentistry in Harrison, AR
• Providers in Harrison, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; 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.