DR. MARK SPANGLER WALLACE (NPI# 1669467213) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669467213 |
| Entity Type | Individual |
| Full Name | DR. MARK SPANGLER WALLACE |
| Credential | DDS |
| Practice Address |
168 N 1950 W Ste 202 Salt Lake City UT 84116-3007 |
| Practice Telephone | 8017153400 |
| Mailing Telephone | 8017153400 |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2020-04-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
142818-9921 | UT | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538533005 | Mark Thomas Wallace | Speech-Language Pathologist | 2337 N 2nd St, Harrisburg, PA 17110-1009 | 2015-11-21 |
| 1942241096 | Mark Alan Wallace | Chiropractor | 2140 W Poplar Ave, Suite 107, Collierville, TN 38017-0624 | 2006-06-09 |
| 1932104205 | Mark Randall Wallace | Internal Medicine | 13400 E Shea Blvd, Scottsdale, AZ 85259 | 2005-06-14 |
| 1760753008 | Mark Edward Wallace | Psychiatry & Neurology | 77 7th Ave, #19d, New York, NY 10011-6645 | 2012-01-18 |
| 1205110434 | Mark James Wallace | Pharmacist | 301 S Sante Fe Ave, Edmond, OK 73003 | 2011-10-06 |
| 1932367539 | Mark Richard Wallace | Chiropractor | 9337 W 75th St, Overland Park, KS 66204 | 2008-05-30 |
| 1316119548 | Mark Steven Wallace | Hearing Instrument Specialist | 202 Grand Ave, Spencer, IA 51301 | 2008-03-27 |
| 1952591828 | Mark Allen Wallace | Otolaryngology | 333 Magazine St, Suite 101, Sault Sainte Marie, MI 49783-1867 | 2007-07-27 |
| 1104047190 | Mark C Wallace | Dentist | 50 County Road B E, Saint Paul, MN 55117-1927 | 2007-05-01 |
| 1548358047 | Mark Arthur Wallace | Dentist | 1901 Research Blvd, Suite 200, Rockville, MD 20850-3164 | 2006-10-10 |
| Street Address |
168 N 1950 W STE 202 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84116-3007 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689281818 | Devery White | Case Manager/Care Coordinator | 195 N 1900 W, Salt Lake City, UT 84116 | 2020-10-01 |
| 1114402377 | Felicia Marie Speer | Community Health Worker | 1303 Sir Phillip Dr, Salt Lake City, UT 84116 | 2018-10-03 |
| 1982144341 | Sharlena Schacht | Pharmacy Technician | 1040 North 2200 West, Salt Lake City, UT 84116 | 2017-03-06 |
| 1316300460 | Riverside Family Dental Care, Inc | Clinic/Center | 1614 W 700 N, Salt Lake City, UT 84116 | 2016-04-05 |
| 1174882856 | Marilyn Ross | Nurse Practitioner | 384 Wright Brothers Dr., Marilyn Ross Bld #2, Salt Lake City, UT 84116 | 2012-05-15 |
| 1720387137 | Lifetime Products Inc. | Durable Medical Equipment & Medical Supplies | 745 N Warm Springs Rd, Salt Lake City, UT 84116 | 2011-03-24 |
| 1811000276 | Kim Coston Christensen | Preventive Medicine | 2150 West 700 North, Kim C. Christensen D.o. Faa Sl/artcc Mfo, Salt Lake City, UT 84116 | 2006-08-17 |
| 1144705583 | Brian Larry Gashler | Family Medicine | 54 N 8th W, Salt Lake City, UT 84116 | 2018-10-02 |
| 1528350972 | Aliesha Shaw | Student in an Organized Health Care Education/Training Program | 26 South 2000 East, 5900, Salt Lake City, UT 84116 | 2011-05-04 |
| 1427035187 | Sarah Lynn Woolsey | Family Medicine | 1365 W 1000 N, Salt Lake City, UT 84116 | 2005-12-23 |
| Find all providers in zip 84116 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417575879 | Utah Family Dental Cottonwood Heights | Dentist | 7069 S Highland Dr Ste 200, Salt Lake City, UT 84121-3731 | 2020-07-10 |
| 1437772498 | Jordan Ames Whatcott | Dentist | 5888 S 900 E Ste 101, Salt Lake City, UT 84121-1644 | 2020-05-26 |
| 1043871783 | Morgan Park | Dentist | 223 S 700 E Ste 3, Salt Lake City, UT 84102-2174 | 2019-06-24 |
| 1730647330 | Salt Lake Modern Dentistry, LLP | Dentist | 1028 E 2100 S Ste 3, Salt Lake City, UT 84106-3096 | 2019-03-04 |
| 1336615244 | Jordan Heimer | Dentist | 1386 S Green St, Salt Lake City, UT 84105-2137 | 2018-10-18 |
| 1558852269 | Eric Gordon Russell | Dentist | 4465 S 900 E Ste 100, Salt Lake City, UT 84124-2695 | 2018-05-29 |
| 1851896484 | Shivani Chowdhary | Dentist | 370 E South Temple Ste 350, Salt Lake City, UT 84111 | 2018-03-26 |
| 1538687207 | Community Health Centers, Inc. | Dentist | 1078 S 300 E # 4, Salt Lake City, UT 84111-4638 | 2017-09-01 |
| 1700315462 | Nelson & Tillmann Family Dentistry, PC | Dentist | 5872 S. 900 E. Ste 202, Salt Lake City, UT 84121 | 2017-06-07 |
| 1437682002 | Salt Lake Dental Care | Dentist | 279 E 5900 S Ste 202, Salt Lake City, UT 84107-5425 | 2017-04-10 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84116 |
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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.