DR. JOHN KLINE WALLACE (NPI# 1316038839) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316038839 |
| Entity Type | Individual |
| Full Name | DR. JOHN KLINE WALLACE |
| Credential | DDS |
| Practice Address |
2501 Princess Anne St Fredericksburg VA 22401-3333 |
| Practice Telephone | 5403710004 |
| Mailing Telephone | 5403710004 |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 0401005254 | VA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AETNA | 0821731 | 01 | |
| VA | 7821565 | 05 | |
| ANTHEM BCBS | 080223 | 01 | |
| DORAL DENTAL | 9130 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023508868 | John E Wallace | Physical Therapist | 1060 Nimitzview Dr Ste 205, Cincinnati, OH 45230-4351 | 2018-05-17 |
| 1679900161 | John D Wallace | Counselor | 1455 Nw 53rd St Apt 222, Miami, FL 33142 | 2013-09-30 |
| 1437590973 | John Burton Wallace V | Social Worker | 141 S 5th St Ofc East, Brooklyn, NY 11211 | 2013-07-12 |
| 1346517307 | John Widtsoe Wallace | Specialist | 1091 Southport Dr, Medina, OH 44256-3019 | 2011-11-18 |
| 1225292634 | John Wallace | Anesthesiology | 3420 S Mercy Rd Ste 200, Gilbert, AZ 85297-0423 | 2008-07-15 |
| 1629241070 | John Dean Wallace Jr. | Dentist | 9913 Mission Gorge Rd Unit 1, Santee, CA 92071-3843 | 2008-04-08 |
| 1275663916 | John Robert Wallace | Physical Therapist | 103 W Woodhill Dr, Suite A, Nags Head, NC 27959 | 2007-03-06 |
| 1346379161 | John G Wallace | Psychiatry & Neurology | 17515 N Park Pl N, Shoreline, WA 98133-4803 | 2007-03-05 |
| 1841359775 | John Thomas Wallace | Chiropractor | 3314 Us Highway 431, Albertville, AL 35950 | 2006-12-06 |
| 1144333261 | John Henry Wallace | Dentist | 583 Moull St, Newark, OH 43055-2909 | 2006-08-15 |
| Street Address |
2501 PRINCESS ANNE ST |
| City | FREDERICKSBURG |
| State | VA |
| Zip Code | 22401-3333 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992313415 | Amanda Dodd | Behavior Technician | 1411 Princess Anne, Fredericksburg, VA 22401 | 2020-07-21 |
| 1215567326 | Britteny Whitaker | Behavior Technician | 1411 Princess Ann, Fredericksburg, VA 22401 | 2020-01-17 |
| 1396389433 | Ashley Stanevich | Behavior Technician | 1411 Princess Anne Lane, Fredericksburg, VA 22401 | 2019-11-01 |
| 1265074231 | Anna Kelleher | Behavior Technician | 1411 Princess Anna St, Frericksburg, VA 22401 | 2019-10-11 |
| 1649824152 | Zaan Z Ali | Audiologist | 1708 Fall Hill Ave Suite 100, Fredericksburg, VA 22401 | 2019-08-01 |
| 1790342426 | Michael Williams Jr. | Physician Assistant | 411 B Park Hill Dr, Frederickburg, VA 22401 | 2019-05-29 |
| 1285290965 | Ann Damalie Namabiro | Behavior Technician | 1411 Princess Ann Street, Fredericksburg, VA 22401 | 2019-05-17 |
| 1922579630 | Primary and Urgent Care LLC | Family Medicine | Primary and Urgent Care LLC, 2306 Plank Road Ste 100, Fredericksburg, VA 22401 | 2018-12-07 |
| 1003323056 | Mariah Mazzariello | Behavior Technician | 1411 Princess Anne Stree, Fredericksburg, VA 22401 | 2017-12-29 |
| 1336655281 | Hina Zafar | Behavior Technician | 1411 Princess Anne St., Fredericksburg, VA 22401 | 2017-12-14 |
| Find all providers in zip 22401 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295345247 | Gretchen Lois Lochte | Dentist | 814 S Milam St, Fredericksburg, TX 78624-4120 | 2020-08-05 |
| 1558841593 | Yurim Jang | Dentist | 10524 Spotsylvania Ave Ste 104, Fredericksburg, VA 22408-8611 | 2018-08-20 |
| 1629573423 | Paul Jiral Dds & Associates PC | Dentist | 560 Celebrate Virginia Pkwy Ste 107, Fredericksburg, VA 22406-7298 | 2018-03-26 |
| 1023545290 | Helen Pham | Dentist | 1420 Central Park Blvd Ste 201, Fredericksburg, VA 22401-4932 | 2017-05-17 |
| 1780120717 | Ali Al-douri | Dentist | 10009 Southpoint Pkwy Ste 201, Fredericksburg, VA 22407-2710 | 2017-01-14 |
| 1215325055 | Sean Kim Dds PC | Dentist | 10861 Tidewater Trl, Fredericksburg, VA 22408-2048 | 2015-01-01 |
| 1811394463 | Priyanka Dental P.c | Dentist | 754 Warrenton Rd, Suite 103, Fredericksburg, VA 22406-1098 | 2014-11-25 |
| 1487057865 | Jennifer Wadiak | Dentist | 131 Park Hill Dr, Ste A, Fredericksburg, VA 22401 | 2014-09-30 |
| 1194151449 | Mohamed Elnahass | Dentist | 200 Executive Center Pkwy Ste 104, Fredericksburg, VA 22401 | 2013-09-18 |
| 1730513441 | Waradah K Eargle | Dentist | 101 Backridge Ct, Fredericksburg, VA 22406-6455 | 2013-08-29 |
| Find all providers in FREDERICKSBURG | ||||
| City | FREDERICKSBURG |
| Zip Code | 22401 |
Please comment or provide details below to improve the information on DR. JOHN KLINE WALLACE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.