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PHILLIP WENDELL WALLACE D.D.S.
NPI 1083759930
Dentist - General Practice in Willoughby, OH

Active since February 20, 2007PECOS Enrolled
36001 EUCLID AVE STE A15, WILLOUGHBY, OH 44094(440) 946-5484(440) 946-5810 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Phillip Wendell Wallace D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PHILLIP WENDELL WALLACE D.D.S. (NPI 1083759930) is an individual general practice provider in Willoughby, Ohio, licensed in Ohio (16266) and active in the NPI registry since February 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1083759930
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NamePHILLIP WENDELL WALLACECredential: D.D.S.
Location Address36001 EUCLID AVE STE A15Willoughby, OH 44094-4643
Mailing Address36001 Euclid Ave Ste A15Willoughby, OH 44094-4643 · (440) 946-5484 · Fax (440) 946-5810
Phone(440) 946-5484
Fax(440) 946-5810
Sole ProprietorYes
Enumeration DateFebruary 20, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1083759930 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in OH · 16266
Definition

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.

36001 EUCLID AVE STE A15, Willoughby, OH 44094
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Delta Dental of Ohio, Guardian, HRI Dental & Vision and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Phillip Wendell Wallace D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 44094 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$68.07 typical visit price
range $17.10 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Phillip Wallace's NPI number?

The NPI number for Phillip Wallace is 1083759930. It was assigned to this individual provider in the NPPES registry on February 20, 2007.

Where is Phillip Wallace located?

Phillip Wallace practices at 36001 Euclid Ave Ste A15, Willoughby, OH 44094. The listed phone number is (440) 946-5484.

What is Phillip Wallace's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Phillip Wallace enrolled in Medicare?

Yes. Phillip Wallace is registered in the Medicare PECOS enrollment system.

What insurance does Phillip Wallace accept?

Health plans from Delta Dental of Ohio, Guardian, HRI Dental & Vision, Humana and MedMutual and 1 other insurer list Phillip Wallace as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Phillip Wallace was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.