Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1740640036 Individual Practitioner Male Practitioner

Dr. Adam Wallum , DMD

Dentist - General Practice • Eglin Afb, FL

Professional Overview & Biography Verified Profile Summary

Dr. Adam Wallum, DMD is a registered healthcare professional specializing in Dentist - General Practice in Eglin Afb, FL. Practice services are available at 307 BOATNER RD STE 114 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

307 Boatner Rd Ste 114

Eglin Afb, FL 325421302

Telephone 8508838803
Associated Practice Facility / Clinic
🏢 96th Medgrp-Eglin Facility NPI 1083012223

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Eglin Afb, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 15.0 Yrs
Regional Practice Density
16 Specialists

Practicing in Eglin Afb, FL (7473 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

CMS Verified: 2025-07-28
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License FL DN22266

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.

Dentist

NUCC Taxonomy Code: 122300000X

State License FL DN22266

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.

Practice Associates & Co-Workers

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

40 Associated Practitioners
Dr. Lucas Petkewitz , DPT

Physical Therapist

NPI 1003228057

Doctor of Physical Therapy

James Saxton

Anesthesiology

NPI 1003435538
Dr. Boden Port , DO

General Practice

NPI 1003519919

Doctor of Osteopathic Medicine (D.O.)

NPI 1013087873

Doctor of Osteopathic Medicine (D.O.)

Dr. Anjeli Pope , MD

Internal Medicine

NPI 1013199181

Doctor of Medicine (M.D.)

Dr. Eric Weiss , MD

General Practice

NPI 1013370444

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

14 Historical Events
📍
Updated Practice Location July 28, 2025

Registered at 307 BOATNER RD STE 114, EGLIN AFB, FL 325421302 (Tel: 8508838803)

📍
Updated Business Mailing Address July 28, 2025

Registered at 307 BOATNER RD STE 114, EGLIN AFB, FL 325421302

📍
Updated Practice Location July 13, 2023

Registered at 1100 WILFORD HALL LOOP, JBSA LACKLAND, TX 782365638 (Tel: 2102920754)

📍
Updated Business Mailing Address July 13, 2023

Registered at 1615 TRUEMPER ST RM B217, JBSA LACKLAND, TX 782365511

📍
Updated Practice Location April 10, 2018

Registered at 1381 S PATRICK DR BLDG 1380, PATRICK AFB, FL 329253606 (Tel: 3214946366)

📍
Updated Business Mailing Address April 10, 2018

Registered at 3088 CONSTELLATION DR, MELBOURNE, FL 329402360 (Tel: 3523422432)

👤
Provider Name / Credentials Updated April 10, 2018

Recorded as ADAM WALLUM, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 10, 2018

Dentist (License #DN22266 in FL)

NPI Profile Active February 29, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location February 29, 2016

Registered at 7677 W PARADISE LN, APT 1128, PEORIA, AZ 853824961 (Tel: 3523422432)

📍
Updated Business Mailing Address February 29, 2016

Registered at 7677 W PARADISE LN, APT 1128, PEORIA, AZ 853824961 (Tel: 3523422432)

👤
Provider Name / Credentials Updated February 29, 2016

Recorded as ADAM WALLUM

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 29, 2016

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration February 29, 2016

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: 1740640036
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 29, 2016
Last Update: July 28, 2025
Sole Proprietor: Yes

Mailing Address

307 Boatner Rd Ste 114

Eglin Afb, FL 325421302

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.