DR. JEFFREY H WALLEN (NPI# 1497729396) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497729396 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY H WALLEN |
| Credential | DDS |
| Practice Address |
1200 48th Ave N Suite 101 Myrtle Beach SC 29577-5425 |
| Practice Telephone | 8434494993 |
| Practice Fax Number | 8434970647 |
| Mailing Telephone | 8434494993 |
| Mailing Fax Number | 8434970647 |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgery | 2959 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | ZA9905 | 05 | |
| NC | 8998844 | 05 |
| Street Address |
1200 48TH AVE N SUITE 101 |
| City | MYRTLE BEACH |
| State | SC |
| Zip Code | 29577-5425 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124536446 | Well Care Home Health of The Lowcountry | Home Health | 1039 44th Ave N Ste 101, Myrtle Beach, SC 29577 | 2018-01-22 |
| 1518470913 | Guillot Enterprises, LLC | Hearing Instrument Specialist | 1294 Professional Dr., Suite C, Myrtle, SC 29577 | 2017-11-08 |
| 1598288227 | Ryan Shepherd | Pharmacist | 1705 South Kings Highway, Myrtle Beach, SC 29577 | 2017-07-25 |
| 1184176554 | Shannon Long | Counselor | 1293 Professional Drive, Suite D Office 222, Myrtle Beach, SC 29577 | 2016-11-01 |
| 1265898191 | Coastal Carolina Infectious Disease, LLC | Internal Medicine | 1110 London St Ste 102, Myrtle Beach, SC 29577 | 2016-01-07 |
| 1548639933 | Susan Lang | Social Worker | 1273 Professional Dr., Suite A #104, Myrtle Beach, SC 29577 | 2015-09-16 |
| 1043600893 | Kenneth Edward Smith | Counselor | 1125 48th Avenue North, Myrtle Beach, SC 29577 | 2015-02-02 |
| 1902203615 | Sc Nursing Services LLC | Home Infusion | 1297 Professional Drive, Suite 201 C3, Myrtle Beach, SC 29577 | 2014-11-24 |
| 1881007946 | Intercoastal Endo, PC | Dentist | 4382 Oleander Dr, Myrtle Beach, SC 29577 | 2014-06-06 |
| 1891115739 | Julie Hite | Pharmacist | 540 Seaboard Street, Myrtle Beach, SC 29577 | 2014-04-18 |
| Find all providers in zip 29577 | ||||
| Taxonomy Code | 204E00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Oral & Maxillofacial Surgery |
| Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. |
| Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437763661 | Charleston Jaw Surgery | Oral & Maxillofacial Surgery | 846 St. Andrews Blvd., Charleston, SC 29407 | 2020-09-04 |
| 1265930697 | Palmetto Ofs, LLC | Oral & Maxillofacial Surgery | 2849 N Pleasantburg Dr, Greenville, SC 29609-3034 | 2018-01-31 |
| 1730602319 | Shelbourne & Associates Oral and Facial Surgery | Oral & Maxillofacial Surgery | 198 Rutledge Ave Ste 4, Charleston, SC 29403-5834 | 2017-07-25 |
| 1861913022 | Drs Misiek, Farrell, Farrell, Nale, Cook, Kapitan, Mohamed & Franco Pa | Oral & Maxillofacial Surgery | 1761 Ebenezer Road, Rock Hill, SC 29732 | 2017-06-28 |
| 1659543148 | Robert L. Coles, Dmd | Oral & Maxillofacial Surgery | 15b Winchester Ct, Mauldin, SC 29662-2626 | 2008-03-25 |
| 1174666283 | Leonard Edward Mcgaha | Oral & Maxillofacial Surgery | 1514 N Fant St, Anderson, SC 29621-4708 | 2007-02-15 |
| 1376642710 | Harry Clinton Belk Jr. | Oral & Maxillofacial Surgery | 115 Powell Mill Road, Spartanburg, SC 29301 | 2006-09-22 |
| 1912019001 | Jonna J Moreschi | Oral & Maxillofacial Surgery | 1021 Maxwell Mill Road, Suite #e, Fort Mill, SC 29708 | 2006-08-31 |
| 1790720043 | James B Tankersley Jr. | Oral & Maxillofacial Surgery | 4103 E North St, Greenville, SC 29615 | 2006-06-19 |
| 1588629638 | Philip M Prickett | Oral & Maxillofacial Surgery | 1311 Chuck Dawley Blvd, Suite 101, Mt Pleasant, SC 29464-7303 | 2006-04-20 |
| Find all providers with the same taxonomy | ||||
| City | MYRTLE BEACH |
| Zip Code | 29577 |
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| 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.