John Brian Wallace, DDS

General Practice Dentistry · Los Alamitos, CA

Individual Active NPI

NPI number 1518094598

Practice location

3551 Farquhar Ave Ste 102
Los Alamitos, CA 90720-2003
Phone
(562) 598-4111

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NPI record

NPI
1518094598
Entity type
Individual (Type 1)
Enumeration date
February 27, 2007
Last updated
July 8, 2007
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X 41046 CA

About Dr. Wallace

John Brian Wallace, DDS is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 3551 Farquhar Ave Ste 102, Los Alamitos, CA 90720-2003. The NPI number 1518094598 was assigned on February 27, 2007 and the record was last updated on July 8, 2007.

Dr. Wallace lists a license in the registry: #41046 (CA) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of John Brian Wallace, DDS?

The NPI number is 1518094598.

What is the phone number of Dr. Wallace?

The phone number listed for the practice location is (562) 598-4111.

Where is Dr. Wallace located?

3551 Farquhar Ave Ste 102, Los Alamitos, CA 90720-2003.

What is the taxonomy code for Dr. Wallace?

The primary taxonomy code is 1223G0001X – General Practice Dentistry.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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