DR. RICHARD J WALLACE (NPI# 1972596443) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972596443 |
| Entity Type | Individual |
| Full Name | DR. RICHARD J WALLACE |
| Credential | D.D.S. |
| Practice Address |
20921 E Smoky Hill Rd Suite A Centennial CO 80015 |
| Mailing Address |
20921 E Smoky Hill Road Suite A Centennial CO 80015 |
| Practice Telephone | 3036907778 |
| Practice Fax Number | 3036901158 |
| Mailing Telephone | 3036907778 |
| Mailing Fax Number | 3036901158 |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2010-09-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
105208 | CO | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811434400 | Richard Wallace | Registered Nurse | 4905 Hackamore Dr N, Colorado Springs, CO 80918-2632 | 2017-01-20 |
| 1023242112 | Richard Lance Wallace | Physical Therapist | 1034 Buchanan Bridge Rd, Chesterfield, SC 29709-6154 | 2009-05-05 |
| 1063656262 | Richard Scott Wallace | Social Worker | 10625 Redmond Rd, Austin, TX 78739-1654 | 2009-05-01 |
| 1710105911 | Richard Franklin Wallace | Marriage & Family Therapist | 3341 M St, Merced, CA 95348-2714 | 2007-04-23 |
| 1326199043 | Richard J. Wallace | Counselor | 1930 Stuart St, Berkeley, CA 94703-2215 | 2007-01-16 |
| 1750458402 | Richard Dean Wallace | Nutritionist | 914 13th Ave South, Great Falls, MT 59405 | 2006-11-29 |
| 1427155001 | Richard Lange Wallace | Psychiatry & Neurology | 8858 Scenic Bay Dr, Las Vegas, NV 89117-1026 | 2006-09-17 |
| 1275586448 | Richard Peterkin Wallace | Family Medicine | 1001 S Fort Harrison Ave, Suite 101, Clearwater, FL 33756-3941 | 2006-05-18 |
| 1881656940 | Richard M. Wallace | Specialist | 925 Highland Blvd., Suite 1180, Bozeman, MT 59715 | 2006-04-04 |
| 1154678332 | Richard Paul Wallace | Pharmacist | Psc 80, Box 13059, Apo, AP 96367-9998 | 2012-08-07 |
| Street Address |
20921 E SMOKY HILL RD SUITE A |
| City | CENTENNIAL |
| State | CO |
| Zip Code | 80015 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326399254 | Eye Care Professional LLC | Optometrist | 20921 E Smoky Hill Rd, Suite B, Centennial, CO 80015-5120 | 2012-10-02 |
| 1861770075 | Darren Jones | Optometrist | 20921 E Smoky Hill Rd, Suite B, Centennial, CO 80015-5120 | 2011-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679128326 | Heather Hartleroad | Counselor | 21699 E Quincy Ave Unit F, #352, Aurora, CO 80015 | 2019-08-08 |
| 1033602792 | 4abilities, LLC. | Non-emergency Medical Transport (VAN) | 5105 S Valdai Street, Aurora, CO 80015 | 2018-06-07 |
| 1952827719 | 1st Centennial Home Health LLP | Home Health | 5418 S Danube Way, Centennial, CO 80015 | 2017-08-14 |
| 1881132157 | 1st Allergy Asthma and Pediatrics Too, Inc. | Specialist | 15470 E Smoky Hill Road, Aurora, CO 80015 | 2017-02-07 |
| 1467909028 | Silver Touch Home Care | In Home Supportive Care | 21804 E. Lake Pl, Aurora, CO 80015 | 2016-09-01 |
| 1417302514 | Michelle Dinges | Dietitian, Registered | 5606 S Helena Ct, Centennial, CO 80015 | 2016-04-27 |
| 1043664907 | Gomgom Siregar | Home Health Aide | 5235 S Liverpool Way, Centennial, CO 80015 | 2016-04-18 |
| 1104280528 | Lloyd Reliford | Custodial Care Facility | 5556 S Jericho Way, Centennial, CO 80015 | 2016-04-12 |
| 1003279563 | Victoria Care Services | Respite Care | 17285 E Wagontrail Pkwy, Aurora, CO 80015 | 2016-04-01 |
| 1699130104 | Gina Michelle Fernandez | Physician Assistant | 14813 E Radcliff Pl, Aurora, CO 80015 | 2015-12-28 |
| Find all providers in zip 80015 | ||||
| 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 |
|---|---|---|---|---|
| 1477177715 | Nathaniel Rivera | Dentist | 6950 S Holly Cir Ste 202, Centennial, CO 80112-7403 | 2020-06-02 |
| 1578101200 | Colorado Dental Professionals, LLC | Dentist | 8290 S Holly St Ste A, Centennial, CO 80122-4029 | 2019-12-12 |
| 1063053288 | Dylan Leto | Dentist | 19245 E Smoky Hill Rd Unit B, Centennial, CO 80015-3122 | 2019-09-30 |
| 1356859243 | Sridevi Kaul | Dentist | 6565 South Syracuse Way, Apartment 1908, Centennial, CO 80111-8011 | 2018-01-13 |
| 1922518208 | Peter Kim | Dentist | 15737 E Prentice Dr, Centennial, CO 80015-4264 | 2017-10-02 |
| 1841678414 | Gary G Wolfson, D.d.s. Pllc | Dentist | 14000 E Arapahoe Rd # C310, Centennial, CO 80112-4043 | 2015-05-14 |
| 1750728572 | Neda Karami | Dentist | 20709 E Euclid Dr, Centennial, CO 80016-3139 | 2013-06-03 |
| 1316280092 | Corbin Kevin Popp | Dentist | 9085 E Mineral Cir Ste 220, Centennial, CO 80112-3400 | 2013-04-01 |
| 1578874129 | Kathryn Buss | Dentist | 2330 E Arapahoe Rd Ste 900, Centennial, CO 80122-3299 | 2010-06-29 |
| 1194957415 | Southglenn Modern Dentistry, LLP | Dentist | 2330 E Arapahoe Rd, Suite 900, Centennial, CO 80122-1508 | 2009-08-20 |
| Find all providers in CENTENNIAL | ||||
| City | CENTENNIAL |
| Zip Code | 80015 |
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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.