Eric Michael Wallace, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

52016 Issued in CA

Practice address

1515 State St
Suite 9
Santa Barbara, CA 93101-2536

Phone

(805) 962-7933

Fax

(805) 962-7234

NPI assigned

Feb 15, 2007

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891838991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 STATE ST",
            "address_2": "SUITE 9",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931012536",
            "telephone_number": "805-962-7933",
            "fax_number": "805-962-7234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 STATE ST",
            "address_2": "SUITE 9",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931012536",
            "telephone_number": "805-962-7933",
            "fax_number": "805-962-7234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "ERIC",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "52016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheila K Walker, MA, AMFT
• Taryn Leigh Walker
• Georgette Walkins, CATC-II
• Ryan Michael Walkow, B.A.
• Carolyn M Wall
• Maureen L Wallace, AU
• Meghan M Wallman, MD
• George Reynolds Walseth I, DDS
• Kelly Elizabeth Walsh, MS, ATC, LAT, PES
• Rachel Walsh

• Oral and Maxillofacial Surgery (Dentist) in Santa Barbara, CA
• Providers in Santa Barbara, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.