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WAYNE CARROLL WALLACE DDS
NPI 1154460459
Dentist - General Practice in Cincinnati, OH

Active since February 05, 2007PECOS Enrolled
3972 RED BANK RD, SUITE E, CINCINNATI, OH 45227(513) 561-9900(513) 561-9902 Get Directions Write a Review

NPPES record last updated: November 6, 2014. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Wayne Carroll Wallace Dds NPPES

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

WAYNE CARROLL WALLACE DDS (NPI 1154460459) is an individual general practice provider in Cincinnati, Ohio, licensed in Ohio (19098) and active in the NPI registry since February 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1154460459
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameWAYNE CARROLL WALLACECredential: DDS
Location Address3972 RED BANK RD, SUITE ECincinnati, OH 45227-3425
Mailing Address3972 Red Bank Rd, Suite ECincinnati, OH 45227-3425 · (513) 561-9900 · Fax (513) 561-9902
Phone(513) 561-9900
Fax(513) 561-9902
Sole ProprietorNo
Enumeration DateFebruary 5, 2007
Last NPPES UpdateNovember 6, 2014
✔ NPI 1154460459 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 · 19098
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.
3972 RED BANK RD, Cincinnati, OH 45227
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Other Identifiers 1

Medicaid0815854OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Wayne Carroll Wallace Dds 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.

Medicare Billing Reassignment

Medicare enrollment records show Wayne Wallace reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mobile Medical, Inc.
170 mi
Podiatrist
740 COMMERCE DR STE A
Perrysburg, OH 43551
  • Reassigned Medicare billing, Ohio enrollment
  • 166 clinicians in this Medicare group
NPI 1003066747 (502) 244-2420

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45227 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 Wayne Wallace's NPI number?

The NPI number for Wayne Wallace is 1154460459. It was assigned to this individual provider in the NPPES registry on February 5, 2007.

Where is Wayne Wallace located?

Wayne Wallace practices at 3972 Red Bank Rd Suite E, Cincinnati, OH 45227. The listed phone number is (513) 561-9900.

What is Wayne Wallace's specialty?

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

Is Wayne Wallace enrolled in Medicare?

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

Which organization bills Medicare for Wayne Wallace's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Wayne Wallace reassigns Medicare benefits to Mobile Medical, Inc. (Perrysburg, OH). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Wayne Wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Wayne Wallace accept?

Health plans from BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and DentaQuest Insurance Company Inc- OH and 11 other insurers list Wayne 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 Wayne Wallace was last updated on November 6, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years 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.