DR. STEPHEN C. WALLER, DDS, LLC
NPI 1992984173
Dentist - General Practice in Ellington, MO

Active since October 24, 2007
115 WALNUT ST, ELLINGTON, MO 63638(573) 756-4344(573) 756-4699 Get Directions Write a Review

NPPES record last updated: January 22, 2009. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Stephen C. Waller, Dds, Llc NPPES

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

DR. STEPHEN C. WALLER, DDS, LLC (NPI 1992984173) is a healthcare organization registered as a general practice in Ellington, Missouri and active in the NPI registry since October 2007. The organization lists Stephen C. Waller, Dentist, as its authorized official.

NPPES Registry Identity

NPI1992984173
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameDR. STEPHEN C. WALLER, DDS, LLC
Location Address115 WALNUT STEllington, MO 63638
Mailing AddressPo Box 157, 110 S. 2nd StEllington, MO 63638-0157 · (573) 663-2313 · Fax (573) 663-2322
Fax(573) 756-4699
Organization SubpartNo
Authorized OfficialStephen C. WallerDentist · (573) 756-4344
Enumeration DateOctober 24, 2007
Last NPPES UpdateJanuary 22, 2009
NPI 1992984173 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License Licensed in MO · 1999135982
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.

115 WALNUT ST, Ellington, MO 63638

Other Identifiers 1

Other1578574240MO · Type 1 Npi Number

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

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

Dental Hygienist
115 WALNUT ST
ELLINGTON, MO 63638
Clinic/Center (Federally Qualified Health Center (FQHC))
115 WALNUT ST
ELLINGTON, MO 63638

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1992984173, enumerated as an "organization" on October 24, 2007.

The provider is located at 115 WALNUT ST ELLINGTON, MO 63638 and the phone number is (573) 756-4344.

Dentist with taxonomy code 1223G0001X and a focus in General Practice.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.