GINA WALLACE
NPI 1417699505
Dental Hygienist in Brunswick, GA

Active since April 10, 2022
4741 ALTAMA AVE, BRUNSWICK, GA 31520(912) 262-1081 Get Directions Write a Review

NPPES record last updated: April 10, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Gina Wallace NPPES

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

GINA WALLACE (NPI 1417699505) is an individual dental hygienist in Brunswick, Georgia, licensed in Georgia (DH043989) and active in the NPI registry since April 2022.

NPPES Registry Identity

NPI1417699505
Entity TypeIndividualFemale
Primary Taxonomy124Q00000X
Provider Legal NameGINA WALLACE
Location Address4741 ALTAMA AVEBrunswick, GA 31520-2910
Mailing Address4741 Altama AveBrunswick, GA 31520-2910 · (912) 262-1081
Sole ProprietorYes
Enumeration DateApril 10, 2022
NPPES CertifiedApril 10, 2022
NPI 1417699505 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDental HygienistDental Providers
Taxonomy Code124Q00000X
License Licensed in GA · DH043989
Definition

An individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be legally delegated to the dental hygienist vary based on the needs of the dentist, the educational preparation of the dental hygienist and state dental practice acts and regulations, but always include, at a minimum, scaling and polishing the teeth. To avoid misleading the public, no occupational title other than dental hygienist should be used to describe this dental auxiliary.

4741 ALTAMA AVE, Brunswick, GA 31520

Other Providers at the Same Location NPPES

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

Dentist (General Practice)
4741 ALTAMA AVE
BRUNSWICK, GA 31520

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1417699505, enumerated as an "individual" on April 10, 2022.

The provider is located at 4741 ALTAMA AVE BRUNSWICK, GA 31520 and the phone number is (912) 262-1081.

Dental Hygienist with taxonomy code 124Q00000X.