1. Home
  2. Directory
  3. Michigan
  4. Mount Clemens
  5. Dentist
  6. NPI Profile

DR. WALLACE SPURGEON COLVIN III D.D.S.
NPI 1730247222
Dentist - General Practice in Mount Clemens, MI

Active since December 05, 2006PECOS Enrolled
69 SOUTHBOUND GRATIOT AVE, MOUNT CLEMENS, MI 48043(586) 783-7000(586) 783-7003 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Wallace Spurgeon Colvin Iii D.d.s. NPPES

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

DR. WALLACE SPURGEON COLVIN III D.D.S. (NPI 1730247222) is an individual general practice provider in Mount Clemens, Michigan, licensed in Michigan (2901016347) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1730247222
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. WALLACE SPURGEON COLVIN IIICredential: D.D.S.
Location Address69 SOUTHBOUND GRATIOT AVEMount Clemens, MI 48043-5545
Mailing Address69 Southbound Gratiot AveMount Clemens, MI 48043-5545 · (586) 783-7000 · Fax (586) 783-7003
Phone(586) 783-7000
Fax(586) 783-7003
Sole ProprietorNo
Enumeration DateDecember 5, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1730247222 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in MI · 2901016347
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
69 SOUTHBOUND GRATIOT AVE, Mount Clemens, MI 48043
Open in Google Maps ↗

Other Identifiers 1

Medicaid4263930MI

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 Montana and more.Insurance ›

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. Wallace Spurgeon Colvin Iii D.d.s. 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 48043 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
$90.76 typical visit price
range $58.04 – $177.36
Typical copayment $22.69 (range $14.51 – $44.34)
Most-billed visit code 99203
Established Patient
$72.38 typical visit price
range $18.32 – $143.49
Typical copayment $18.09 (range $4.58 – $35.87)
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.

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 Wallace Colvin's NPI number?

The NPI number for Wallace Colvin is 1730247222. It was assigned to this individual provider in the NPPES registry on December 5, 2006.

Where is Wallace Colvin located?

Wallace Colvin practices at 69 Southbound Gratiot Ave, Mount Clemens, MI 48043. The listed phone number is (586) 783-7000.

What is Wallace Colvin's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Wallace Colvin enrolled in Medicare?

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

What insurance does Wallace Colvin accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 8 other insurers list Wallace Colvin 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 Wallace Colvin was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.