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DAVID A. WALLACE, DDS, MS, LTD.
NPI 1356536593
Dentist - Oral and Maxillofacial Surgery in Blacksburg, VA

Active since September 11, 2007
3712 S MAIN ST, BLACKSBURG, VA 24060(540) 552-7222(540) 953-3096 Get Directions Write a Review

NPPES record last updated: September 6, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About David A. Wallace, Dds, Ms, Ltd. NPPES

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

DAVID A. WALLACE, DDS, MS, LTD. (NPI 1356536593) is a healthcare organization registered as an oral and maxillofacial surgery in Blacksburg, Virginia and active in the NPI registry since September 2007. The organization lists Ella Hurst, Ofc. Mngr., as its authorized official.

NPPES Registry Identity

NPI1356536593
Entity TypeOrganization
Primary Taxonomy1223S0112X
Legal Business NameDAVID A. WALLACE, DDS, MS, LTD.
Location Address3712 S MAIN STBlacksburg, VA 24060-7017
Mailing Address3712 S Main StBlacksburg, VA 24060-7017 · (540) 552-7222 · Fax (540) 953-3096
Phone(540) 552-7222
Fax(540) 953-3096
Organization SubpartNo
Authorized OfficialElla HurstOfc. Mngr. · (304) 425-2611
Enumeration DateSeptember 11, 2007
Last NPPES UpdateSeptember 6, 2023
✔ NPI 1356536593 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
Licenses✔ Licensed in VA · 03440✔ Licensed in WV · 1880
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
3712 S MAIN ST, Blacksburg, VA 24060
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Other Identifiers 2

Medicaid0138333000WV
Medicaid8000476VA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

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 David A. Wallace, Dds, Ms, Ltd.'s NPI number?

The NPI number for David A. Wallace, Dds, Ms, Ltd. is 1356536593. It was assigned to this organization in the NPPES registry on September 11, 2007.

Where is David A. Wallace, Dds, Ms, Ltd. located?

David A. Wallace, Dds, Ms, Ltd. is located at 3712 S Main St, Blacksburg, VA 24060. The listed phone number is (540) 552-7222.

What is David A. Wallace, Dds, Ms, Ltd.'s specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

When was this NPI record last updated?

The NPPES record for David A. Wallace, Dds, Ms, Ltd. was last updated on September 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.