DR. BRANDON TOBIAS WALLACE DMD
NPI 1093569204
Dentist - General Practice in Cincinnati, OH

Q: What is Brandon Wallace's NPI number?

The NPI number for Brandon Wallace is 1093569204. It was assigned to this individual provider in the NPPES registry on April 15, 2024.

Q: What is Brandon Wallace's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Brandon Wallace was last updated on October 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 15, 2024

4605 E GALBRAITH RD STE 100, CINCINNATI, OH 45236(513) 961-1991 Get Directions Write a Review

NPPES record last updated: October 1, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Dr. Brandon Tobias Wallace Dmd NPPES

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

DR. BRANDON TOBIAS WALLACE DMD (NPI 1093569204) is an individual general practice provider in Cincinnati, Ohio, licensed in Ohio (30.027636) and active in the NPI registry since April 2024.

NPPES Registry Identity

NPI1093569204

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameDR. BRANDON TOBIAS WALLACECredential: DMD

Location Address4605 E GALBRAITH RD STE 100Cincinnati, OH 45236-2888

Mailing Address345 Harrison Ave Ph 19Boston, MA 02118-4095 · (910) 580-5699

Phone(513) 961-1991

Sole ProprietorNo

Enumeration DateApril 15, 2024

Last NPPES UpdateOctober 1, 2025

NPPES CertifiedOctober 1, 2025

✔ NPI 1093569204 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 · 30.027636

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.

4605 E GALBRAITH RD STE 100, Cincinnati, OH 45236

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CINCINNATI DENTAL GROUP LLC

Clinic/Center (Dental)

4605 E GALBRAITH RD STE 100
CINCINNATI, OH 45236

Hamilton County (513) 961-1991

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 Brandon Wallace's NPI number?

The NPI number for Brandon Wallace is 1093569204. It was assigned to this individual provider in the NPPES registry on April 15, 2024.

Where is Brandon Wallace located?

Brandon Wallace practices at 4605 E Galbraith Rd Ste 100, Cincinnati, OH 45236. The listed phone number is (513) 961-1991.

What is Brandon Wallace's specialty?

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

What insurance does Brandon Wallace accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and BEST Life and 14 other insurers list Brandon 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 Brandon Wallace was last updated on October 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.