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DR. JODY PAUL WALLACE D.D.S.
NPI 1740210103
Dentist - General Practice in Graham, NC

Active since July 03, 2006Opted out of Medicare · through Mar 7, 2028
2148 HIGHWAY 54, GRAHAM, NC 27253(336) 578-3884(336) 578-3814 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Jody Paul Wallace D.d.s. NPPES

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

DR. JODY PAUL WALLACE D.D.S. (NPI 1740210103) is an individual general practice provider in Graham, North Carolina, licensed in North Carolina (7500) and active in the NPI registry since July 2006. He has opted out of Medicare through March 7, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1740210103
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. JODY PAUL WALLACECredential: D.D.S.
Location Address2148 HIGHWAY 54Graham, NC 27253
Mailing Address2148 Highway 54Graham, NC 27253 · (336) 578-3884 · Fax (336) 578-3814
Phone(336) 578-3884
Fax(336) 578-3814
Sole ProprietorNo
Enumeration DateJuly 3, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1740210103 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in NC · 7500
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.
2148 HIGHWAY 54, Graham, NC 27253
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Other Identifiers 1

Medicaid89902J1NC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Delta Dental of North Carolina.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

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Opted out of Medicare

Dr. Jody Paul Wallace D.d.s. 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 March 7, 2016 through March 7, 2028.

Opt-Out Effective DateMarch 7, 2016
Opt-Out In Effect ThroughMarch 7, 2028Opt-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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27253 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
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
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

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

JERRY CRAYLE
Dentist
2148 HIGHWAY 54, JEROME CRAYLE PLLC
GRAHAM, NC 27253
Alamance County (336) 578-3896

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 Jody Wallace's NPI number?

The NPI number for Jody Wallace is 1740210103. It was assigned to this individual provider in the NPPES registry on July 3, 2006.

Where is Jody Wallace located?

Jody Wallace practices at 2148 Highway 54, Graham, NC 27253. The listed phone number is (336) 578-3884.

What is Jody Wallace's specialty?

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

Is Jody Wallace enrolled in Medicare?

No. Jody Wallace has opted out of Medicare through March 7, 2028. 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.

What insurance does Jody Wallace accept?

Health plans from Delta Dental of North Carolina list Jody 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 Jody Wallace 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.