Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1871608604 Individual Practitioner Female Practitioner

Dr. Andrea L Wallace , DMD

Dentist - General Practice • Emmett, ID

Professional Overview & Biography Verified Profile Summary

Dr. Andrea Wallace, DMD is a registered healthcare professional specializing in Dentist - General Practice in Emmett, ID. Practice services are available at 2003 S PLAZA RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2003 S Plaza Rd

Emmett, ID 836179180

Telephone 2083653534
Fax 2083656231
Associated Practice Facility / Clinic
🏢 D & A Wallace, Inc. Facility NPI 1144498437

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Emmett, ID

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 28.3 Yrs
Regional Practice Density
5 Specialists

Practicing in Emmett, ID (781 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 ID D-3656

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
8071026 (ID)

Practice Associates & Co-Workers

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

2 Associated Practitioners
NPI 1245425198

Doctor of Dental Medicine

Dr. Darren Wallace , DMD

Dentist - General Practice

NPI 1841305646

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 July 09, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 09, 2007

Registered at 2003 S PLAZA RD, EMMETT, ID 836179180 (Tel: 2083653534)

📍
Updated Business Mailing Address July 09, 2007

Registered at 2003 S PLAZA RD, EMMETT, ID 836179180 (Tel: 2083653534)

👤
Provider Name / Credentials Updated July 09, 2007

Recorded as ANDREA WALLACE, D.M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 09, 2007

Dentist (License #D-3656 in ID)

🟢
Initial NPI Registration & Enumeration August 20, 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: 1871608604
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 20, 2006
Last Update: July 09, 2007
Sole Proprietor: No

Mailing Address

2003 S Plaza Rd

Emmett, ID 836179180

Phone: 2083653534

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.