Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1689681041 Individual Practitioner Male Practitioner

Dr. Kim Eugene Wallace , DDS

Dentist - General Practice • Davis, CA

Professional Overview & Biography Verified Profile Summary

Dr. Kim Wallace, DDS is a registered healthcare professional specializing in Dentist - General Practice in Davis, CA. Practice services are available at 635 ANDERSON RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

635 Anderson Rd
Suite 17

Davis, CA 956163505

Telephone 5307576453
Fax 5307576450
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Davis, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.7 Yrs
Regional Practice Density
30 Specialists

Practicing in Davis, CA (18734 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 CA 22932

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.

Practice Associates & Co-Workers

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

1 Associated Practitioners
Dr. Samer Alassaad , DDS

Dentist - General Practice

NPI 1104086875

Doctor of Dental Surgery

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active May 11, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location May 11, 2016

Registered at 635 ANDERSON RD, SUITE 17, DAVIS, CA 956163505 (Tel: 5307576453)

📍
Updated Business Mailing Address May 11, 2016

Registered at 635 ANDERSON RD, SUITE 17, DAVIS, CA 956163505 (Tel: 5307576453)

👤
Provider Name / Credentials Updated May 11, 2016

Recorded as KIM WALLACE, D.D.S.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 11, 2016

Dentist (License #22932 in CA)

🟢
Initial NPI Registration & Enumeration August 01, 2006

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: 1689681041
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 01, 2006
Last Update: May 11, 2016
Sole Proprietor: Yes

Mailing Address

635 Anderson Rd, Suite 17

Davis, CA 956163505

Phone: 5307576453

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.