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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. JEFFREY H WALLEN DDS
NPI 1497729396
Oral & Maxillofacial Surgery in Myrtle Beach, SC

Active since February 15, 2006Opted out of Medicare · through Oct 1, 2026
1200 48TH AVE N, SUITE 101, MYRTLE BEACH, SC 29577(843) 449-4993(843) 497-0647 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Jeffrey H Wallen Dds NPPES

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

DR. JEFFREY H WALLEN DDS (NPI 1497729396) is an individual oral & maxillofacial surgery provider in Myrtle Beach, South Carolina, licensed in South Carolina (2959) and active in the NPI registry since February 2006. He has opted out of Medicare through October 1, 2026 and remains eligible to order and refer.

NPPES Registry Identity

NPI1497729396
Entity TypeIndividualMale
Primary Taxonomy204E00000X
Provider Legal NameDR. JEFFREY H WALLENCredential: DDS
Location Address1200 48TH AVE N, SUITE 101Myrtle Beach, SC 29577-5425
Mailing Address1200 48th Ave N, Suite 101Myrtle Beach, SC 29577-5425 · (843) 449-4993 · Fax (843) 497-0647
Phone(843) 449-4993
Fax(843) 497-0647
Sole ProprietorNo
Enumeration DateFebruary 15, 2006
Last NPPES UpdateJuly 13, 2026
✔ NPI 1497729396 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code204E00000X
License✔ Licensed in SC · 2959
Definition
Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.
1200 48TH AVE N, Myrtle Beach, SC 29577
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Other Identifiers 2

MedicaidZA9905SC
Medicaid8998844NC

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Jeffrey H Wallen Dds has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 1, 2020 through October 1, 2026.

Opt-Out Effective DateOctober 1, 2020
Opt-Out In Effect ThroughOctober 1, 2026Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES

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

SARA BEER
Social Worker
1200 48TH AVE N
MYRTLE BEACH, SC 29577
Horry County (910) 604-4449

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 Jeffrey Wallen's NPI number?

The NPI number for Jeffrey Wallen is 1497729396. It was assigned to this individual provider in the NPPES registry on February 15, 2006.

Where is Jeffrey Wallen located?

Jeffrey Wallen practices at 1200 48th Ave N Suite 101, Myrtle Beach, SC 29577. The listed phone number is (843) 449-4993.

What is Jeffrey Wallen's specialty?

The primary specialty registered for this NPI is Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

Is Jeffrey Wallen enrolled in Medicare?

No. Jeffrey Wallen has opted out of Medicare through October 1, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Jeffrey Wallen 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 27 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.