DR. TANNER WALLACE D.M.D.
NPI 1932514130
Dentist in Hanover, NH

Q: What is Tanner Wallace's NPI number?

The NPI number for Tanner Wallace is 1932514130. It was assigned to this individual provider in the NPPES registry on June 25, 2014.

Q: What is Tanner Wallace's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for Tanner Wallace was last updated on November 7, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.

Active since June 25, 2014PECOS Enrolled

73 LYME RD, SUITE 3, HANOVER, NH 03755(603) 643-3509 Get Directions Write a Review

NPPES record last updated: November 7, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Tanner Wallace D.m.d. NPPES

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

DR. TANNER WALLACE D.M.D. (NPI 1932514130) is an individual dentist in Hanover, New Hampshire, licensed in New Hampshire (04057) and active in the NPI registry since June 2014. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1932514130

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameDR. TANNER WALLACECredential: D.M.D.

Location Address73 LYME RD, SUITE 3Hanover, NH 03755-1207

Mailing Address73 Lyme Rd, Suite 3Hanover, NH 03755-1207 · (603) 643-3509

Phone(603) 643-3509

Sole ProprietorNo

Enumeration DateJune 25, 2014

Last NPPES UpdateNovember 7, 2014

✔ NPI 1932514130 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in NH · 04057

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

73 LYME RD, Hanover, NH 03755

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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. Tanner Wallace D.m.d. 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 03755 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

$89.14 typical visit price

range $57.75 – $174.26

Typical copayment $22.28 (range $14.43 – $43.56)

Most-billed visit code 99203

Established Patient

$71.85 typical visit price

range $18.70 – $142.15

Typical copayment $17.96 (range $4.67 – $35.53)

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 5

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

TRACEY J DARLING RDH

Dental Hygienist

73 LYME RD, SUITE 3
HANOVER, NH 03755

Grafton County (603) 643-3509

DR. ELAINE M NEAL DMD

Dentist

73 LYME RD, SUITE 3
HANOVER, NH 03755

Grafton County (603) 643-3509

DR. ELAINE NEAL

Dental Hygienist

73 LYME RD, SUITE 3
HANOVER, NH 03755

Grafton County (603) 643-3509

ELAINE M NEAL DMD PA

Dentist

73 LYME RD, SUITE 3
HANOVER, NH 03755

Grafton County (603) 643-3509

DR. STEPHEN ENRICO FUCINI DMD

Dentist (Periodontics)

73 LYME RD, STE #2
HANOVER, NH 03755

Grafton County (603) 643-0501

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 Tanner Wallace's NPI number?

The NPI number for Tanner Wallace is 1932514130. It was assigned to this individual provider in the NPPES registry on June 25, 2014.

Where is Tanner Wallace located?

Tanner Wallace practices at 73 Lyme Rd Suite 3, Hanover, NH 03755. The listed phone number is (603) 643-3509.

What is Tanner Wallace's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Tanner Wallace enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Tanner Wallace was last updated on November 7, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.