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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. MARSHALL LYNN WALLACE DMD
NPI 1124092697
Dentist - Periodontics in Sumter, SC

Active since February 14, 2006PECOS Enrolled
3 PROFESSIONAL CT, SUMTER, SC 29150(803) 469-9461(803) 469-9023 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Marshall Lynn Wallace Dmd NPPES

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

DR. MARSHALL LYNN WALLACE DMD (NPI 1124092697) is an individual periodontics provider in Sumter, South Carolina, licensed in South Carolina (2839/363) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124092697
Entity TypeIndividualMale
Primary Taxonomy1223P0300X
Provider Legal NameDR. MARSHALL LYNN WALLACECredential: DMD
Location Address3 PROFESSIONAL CTSumter, SC 29150-1927
Mailing Address3 Professional CtSumter, SC 29150-1927 · (803) 469-9461 · Fax (803) 469-9023
Phone(803) 469-9461
Fax(803) 469-9023
Sole ProprietorNo
Enumeration DateFebruary 14, 2006
Last NPPES UpdateJuly 13, 2026
✔ NPI 1124092697 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
License✔ Licensed in SC · 2839/363
Definition
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
3 PROFESSIONAL CT, Sumter, SC 29150
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Other Identifiers 1

MedicaidZA9760SC

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Marshall Lynn Wallace Dmd 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 29150 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
$83.18 typical visit price
range $53.57 – $163.84
Typical copayment $20.79 (range $13.39 – $40.96)
Most-billed visit code 99203
Established Patient
$67.12 typical visit price
range $16.96 – $133.52
Typical copayment $16.78 (range $4.24 – $33.38)
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 Marshall Wallace's NPI number?

The NPI number for Marshall Wallace is 1124092697. It was assigned to this individual provider in the NPPES registry on February 14, 2006.

Where is Marshall Wallace located?

Marshall Wallace practices at 3 Professional Ct, Sumter, SC 29150. The listed phone number is (803) 469-9461.

What is Marshall Wallace's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Is Marshall Wallace enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Marshall Wallace was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 38 days 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.