Nancy S. Wallace, D.M.D., LTD.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

NANCY S. WALLACE, D.M.D., LTD.

Practice address

1709 Washington St
Waukegan, IL 60085-5133

Phone

(847) 662-6080

Fax

(847) 662-6086

NPI assigned

May 20, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Nancy Smith Wallace, D.M.D.NPI 1144341876

Title

President

Phone

(847) 662-6080

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nancy Smith Wallace, D.M.D.

  • General Practice Dentistry
  • Waukegan, IL
  • NPI 1144341876
  NPD (past) Authorized official
• Cheska Dekelia Avery, D.D.S.

  • Dentist
  • Waukegan, IL
  • NPI 1770770646
  NPD (past)

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1548214034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1709 WASHINGTON ST",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600855133",
            "telephone_number": "847-662-6080",
            "fax_number": "847-662-6086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 WASHINGTON ST",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600855133",
            "telephone_number": "847-662-6080",
            "fax_number": "847-662-6086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NANCY S. WALLACE, D.M.D., LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "SMITH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-662-6080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maureen McGarrity Murphy, LCSW
• Ujjvala Nadkarni, MD
• Saima D Najam, MD
• Maureen Nakayenze, BSW
• Demetrius Cornell Nance
• Patricia Ann Napier, RN
• Mary Ellen Nash, MSW,LSW
• Erica Nathan
• Katherine Lorelen Nauert-Dineen
• Seetharama Navada, PHARM.D

• General Practice Dentistry in Waukegan, IL
• Providers in Waukegan, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.