DR. MICHAEL JAMES WALLACE DDS
NPI 1124127279
Dentist - General Practice in Green Bay, WI

Active since September 22, 2006
1195 W MASON ST, GREEN BAY, WI 54303(920) 498-3633(920) 498-1099 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Michael James Wallace Dds NPPES

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

DR. MICHAEL JAMES WALLACE DDS (NPI 1124127279) is an individual general practice provider in Green Bay, Wisconsin, licensed in Wisconsin (2515) and active in the NPI registry since September 2006.

NPPES Registry Identity

NPI1124127279
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. MICHAEL JAMES WALLACECredential: DDS
Location Address1195 W MASON STGreen Bay, WI 54303-2045
Mailing Address1195 W Mason StGreen Bay, WI 54303-2045 · (920) 498-3633 · Fax (920) 498-1099
Fax(920) 498-1099
Sole ProprietorYes
Enumeration DateSeptember 22, 2006
Last NPPES UpdateJuly 8, 2007
NPI 1124127279 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License Licensed in WI · 2515
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.

1195 W MASON ST, Green Bay, WI 54303

Accepted Insurance

Other Providers at the Same Location NPPES 2

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

Dentist
1195 W MASON ST
GREEN BAY, WI 54303
Clinic/Center (Dental)
1195 W MASON ST
GREEN BAY, WI 54303

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 Michael Wallace's NPI number?

The NPI number for Michael Wallace is 1124127279. It was assigned to this individual provider in the NPPES registry on September 22, 2006.

Where is Michael Wallace located?

Michael Wallace practices at 1195 W Mason St, Green Bay, WI 54303. The listed phone number is (920) 498-3633.

What is Michael Wallace's specialty?

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

What insurance does Michael Wallace accept?

Health plans from Blue Cross and Blue Shield of Alabama list Michael 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 Michael Wallace was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.