Ashley Wallace, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

39215 Issued in TX

Practice address

17122 Bulverde Rd Ste 102
San Antonio, TX 78247-3211

Phone

(210) 495-2000

NPI assigned

Feb 21, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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.

• Bulverde 7To7 PLLC

  • Dental Clinic/Center
  • San Antonio, TX
  • NPI 1043985070
  NPD
• Ortho 7To7 PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • San Antonio, TX
  • NPI 1427930791
  NPD (past)

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

{
    "created_epoch": "1676937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1821796517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21626 STONEWALL PKWY APT 3312",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782561716",
            "telephone_number": "413-348-4847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17122 BULVERDE RD STE 102",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782473211",
            "telephone_number": "210-495-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "ASHLEY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-21",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "39215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janna Wallace-Lennox, LMFT
• Alexandrea Irene Wallace, MSN, APRN, PMHNP-BC
• Alexandria Lynn Wallace, CPHT
• Andrew Wallace Jr.
• Annmarie Wallace, CRNA
• Chad Ryan Wallace, RN
• Christopher L. Wallace, M.D.
• Cory L Wallace, DPM
• Derek James Wallace
• Diane P. Wallace, OTR

• General Practice Dentistry in San Antonio, TX
• Providers in San Antonio, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; 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.