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LESLIE SUZANNE WALLACE DMD
NPI 1629301833
Dentist - Pediatric Dentistry in Lebanon, TN

Active since September 08, 2009
103 PHYSICIANS WAY, SUITE 150, LEBANON, TN 37090(859) 948-0386 Get Directions Write a Review

NPPES record last updated: January 8, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Leslie Suzanne Wallace Dmd NPPES

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

LESLIE SUZANNE WALLACE DMD (NPI 1629301833) is an individual pediatric dentistry provider in Lebanon, Tennessee, licensed in Tennessee (8973) and active in the NPI registry since September 2009.

NPPES Registry Identity

NPI1629301833
Entity TypeIndividualFemale
Primary Taxonomy1223P0221X
Provider Legal NameLESLIE SUZANNE WALLACECredential: DMD
Location Address103 PHYSICIANS WAY, SUITE 150Lebanon, TN 37090-4104
Mailing Address179 Cobbler CirHendersonville, TN 37075-3963 · (859) 948-0386
Phone(859) 948-0386
Sole ProprietorYes
Enumeration DateSeptember 8, 2009
Last NPPES UpdateJanuary 8, 2014
✔ NPI 1629301833 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
License✔ Licensed in TN · 8973
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
103 PHYSICIANS WAY, Lebanon, TN 37090
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Other Names 1

Former Name (1)Leslie Suzanne Parham Dmd

Accepted Insurance

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

Other Providers at the Same Location NPPES

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

PEDIATRIC DENTISTRY OF LEBANON,PLLC
Dentist (Pediatric Dentistry)
103 PHYSICIANS WAY, STE 150
LEBANON, TN 37090
Wilson County (615) 545-1812

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 Leslie Wallace's NPI number?

The NPI number for Leslie Wallace is 1629301833. It was assigned to this individual provider in the NPPES registry on September 8, 2009. The provider is also known as Leslie Suzanne Parham Dmd.

Where is Leslie Wallace located?

Leslie Wallace practices at 103 Physicians Way Suite 150, Lebanon, TN 37090. The listed phone number is (859) 948-0386.

What is Leslie Wallace's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

What insurance does Leslie Wallace accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 9 other insurers list Leslie 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 Leslie Wallace was last updated on January 8, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.