Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1639172158 Individual Practitioner Female Practitioner

Dr. Martha Cochran Wallace , DMD

Dentist - General Practice • Birmingham, AL

Professional Overview & Biography Verified Profile Summary

Dr. Martha Wallace, DMD is a registered healthcare professional specializing in Dentist - General Practice in Birmingham, AL. Practice services are available at 1400 6TH AVE S under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1400 6th Ave S

Birmingham, AL 352331502

Telephone 2059301015
Fax 2059301448
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Birmingham, AL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.4 Yrs
Regional Practice Density
205 Specialists

Practicing in Birmingham, AL (1455 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License AL 3030

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
1639172158 (AL)
Medicaid State Provider ID
103546 (AL)
Medicaid State Provider ID
103578 (AL)
Medicaid State Provider ID
103678 (AL)
Medicaid State Provider ID
103676 (AL)
Commercial Insurance / Payer ID Blue Cross Blue Shield
510-40460 (AL)
Commercial Insurance / Payer ID Blue Cross Blue Shield
510-40457 (AL)
Commercial Insurance / Payer ID Blue Cross Blue Shield
510-40458 (AL)
Commercial Insurance / Payer ID Blue Cross Blue Shield
510-40459 (AL)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

10 Associated Practitioners
Dr. Teri Chafin , DMD, MPH

Dentist - General Practice

NPI 1114925625

Doctor of Dental Medicine, Master of Public Health

Thomas Gann , DENTIST

Dentist - General Practice

NPI 1154448231
Dr. Heather Manogue , DMD

Dentist - General Practice

NPI 1265635353

Doctor of Dental Medicine

Dr. James Hughes , DMD

Dentist - General Practice

NPI 1336237288

Doctor of Dental Medicine

Dr. James Butts , DMD

Dentist - General Practice

NPI 1376617225

Doctor of Dental Medicine

Dr. Richard Skinner , DMD

Dentist - General Practice

NPI 1407943541

Doctor of Dental Medicine

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active January 05, 2011

NPI status registered as active in NPPES database

📍
Updated Practice Location January 05, 2011

Registered at 1400 6TH AVE S, BIRMINGHAM, AL 352331502 (Tel: 2059301015)

📍
Updated Business Mailing Address January 05, 2011

Registered at 1400 6TH AVE S, BIRMINGHAM, AL 352331502 (Tel: 2059301015)

👤
Provider Name / Credentials Updated January 05, 2011

Recorded as MARTHA WALLACE, D.M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 05, 2011

Dentist (License #3030 in AL)

🟢
Initial NPI Registration & Enumeration May 30, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1639172158
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 30, 2005
Last Update: January 05, 2011
Sole Proprietor: No

Mailing Address

1400 6th Ave S

Birmingham, AL 352331502

Phone: 2059301015

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.