Dr. Charles Wallace, DDS, PS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5882 Issued in WA

Legal business name

DR. CHARLES WALLACE, DDS, PS

Doing business as

Wallace & Solhaug Family Dental

Practice address

3221 Eastlake Ave E Ste 130
Seattle, WA 98102-7125

Phone

(206) 633-5100

Fax

(206) 633-3667

NPI assigned

Feb 27, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Charles E Wallace, DDSNPI 1063584746

Title

Owner

Phone

(206) 633-5100

Specialties & licenses 1

Addresses

Other names 1

• Wallace & Solhaug Family Dental Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles E Wallace, DDS

  • General Practice Dentistry
  • Seattle, WA
  • NPI 1063584746
  NPD (past) Authorized official
• Pamela Solhaug, DDS

  • General Practice Dentistry
  • Seattle, WA
  • NPI 1942337134
  NPD (past)

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962539114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3221 EASTLAKE AVE E STE 130",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981027125",
            "telephone_number": "206-633-5100",
            "fax_number": "206-633-3667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3221 EASTLAKE AVE E STE 130",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981027125",
            "telephone_number": "206-633-5100",
            "fax_number": "206-633-3667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. CHARLES WALLACE, DDS, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-633-5100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "5882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wallace & Solhaug Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Seattle, WA
• Providers in Seattle, WA by specialty
• General Practice Dentistry in Washington

• 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.