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DR. STEPHEN S WALLACE DDS
NPI 1679868822
Dentist - Periodontics in Waterbury, CT

Active since June 16, 2011PECOS Enrolled
140 GRANDVIEW AVE, SUITE 102, WATERBURY, CT 06708(203) 753-1112(203) 573-0773 Get Directions Write a Review

NPPES record last updated: March 29, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Stephen S Wallace Dds NPPES

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

DR. STEPHEN S WALLACE DDS (NPI 1679868822) is an individual periodontics provider in Waterbury, Connecticut, licensed in Connecticut (4383) and active in the NPI registry since June 2011. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1679868822
Entity TypeIndividualMale
Primary Taxonomy1223P0300X
Provider Legal NameDR. STEPHEN S WALLACECredential: DDS
Location Address140 GRANDVIEW AVE, SUITE 102Waterbury, CT 06708-2505
Mailing Address140 Grandview Ave, Suite 102Waterbury, CT 06708-2505 · (203) 753-1112 · Fax (203) 573-0773
Phone(203) 753-1112
Fax(203) 573-0773
Sole ProprietorYes
Enumeration DateJune 16, 2011
Last NPPES UpdateMarch 29, 2012
✔ NPI 1679868822 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
Licenses✔ Licensed in CT · 4383✔ Licensed in NY · 044912-1✔ Licensed in MA · DN11169
Definition
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
140 GRANDVIEW AVE, Waterbury, CT 06708
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Stephen S 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06708 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
$93.86 typical visit price
range $60.82 – $183.10
Typical copayment $23.46 (range $15.20 – $45.77)
Most-billed visit code 99203
Established Patient
$75.55 typical visit price
range $19.76 – $149.26
Typical copayment $18.88 (range $4.94 – $37.31)
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.

Other Providers at the Same Location NPPES 20

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

GIRVICE ARCHER M.D
Anesthesiology
140 GRANDVIEW AVE
WATERBURY, CT 06708
Naugatuck Valley Planning Region (203) 757-7000
DR. LYDIA AOUN-BARAKAT MD
Internal Medicine (Infectious Disease)
140 GRANDVIEW AVE, SUITE #L01
WATERBURY, CT 06708
Naugatuck Valley Planning Region (203) 574-4187
GARY POUPKO M.D
Anesthesiology
140 GRANDVIEW AVE
WATERBURY, CT 06708
Naugatuck Valley Planning Region (203) 757-7000
DR. MAJID SADIGH MD
Internal Medicine (Infectious Disease)
140 GRANDVIEW AVE, SUITE #101
WATERBURY, CT 06708
Naugatuck Valley Planning Region (203) 573-7284
JOSEPH ROCCO
Nurse Anesthetist, Certified Registered
140 GRANDVIEW AVE
WATERBURY, CT 06708
Naugatuck Valley Planning Region (203) 757-7000
DR. WILLIAM D RIFKIN MD
Internal Medicine
140 GRANDVIEW AVE, SUITE #101
WATERBURY, CT 06708
Naugatuck Valley Planning Region (203) 573-7284
JANET L VODRA MD
Obstetrics & Gynecology
140 GRANDVIEW AVE, SUITE 202
WATERBURY, CT 06708
Naugatuck Valley Planning Region (203) 755-2344
RAYMOND CLEMENT M.D
Anesthesiology
140 GRANDVIEW AVE
WATERBURY, CT 06708
Naugatuck Valley Planning Region (203) 757-7000

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 Stephen Wallace's NPI number?

The NPI number for Stephen Wallace is 1679868822. It was assigned to this individual provider in the NPPES registry on June 16, 2011.

Where is Stephen Wallace located?

Stephen Wallace practices at 140 Grandview Ave Suite 102, Waterbury, CT 06708. The listed phone number is (203) 753-1112.

What is Stephen Wallace's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Is Stephen Wallace enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Stephen Wallace was last updated on March 29, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.