Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1396033494 Individual Practitioner Male Practitioner

Dr. Jared S. Wallis , DDS

Dentist • Las Cruces, NM

Professional Overview & Biography Verified Profile Summary

Dr. Jared Wallis, DDS is a registered healthcare professional specializing in Dentist in Las Cruces, NM. Practice services are available at 2540 N TELSHOR BLVD STE E under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2540 N Telshor Blvd Ste E

Las Cruces, NM 880118201

Telephone 5755219375
Fax 5755212637
Associated Practice Facility / Clinic
🏢 Northrise Dental Llc Facility NPI 1437622503

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Las Cruces, NM

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 1.0 Yrs
State Avg: 12.6 Yrs
Regional Practice Density
48 Specialists

Practicing in Las Cruces, NM (630 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 Primary Specialty

NUCC Taxonomy Code: 122300000X

State License NM 3512

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.

Dentist - General Practice

NUCC Taxonomy Code: 1223G0001X

State License NM 3512

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
NPI 1164915294

Doctor of Dental Medicine

Career & Practice History Timeline

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

8 Historical Events
📍
Updated Practice Location February 11, 2019

Registered at 2540 N TELSHOR BLVD STE E, LAS CRUCES, NM 880118201 (Tel: 5755219375)

📍
Updated Business Mailing Address February 11, 2019

Registered at 2540 N TELSHOR BLVD STE E, LAS CRUCES, NM 880118201 (Tel: 5755219375)

NPI Profile Active July 11, 2011

NPI status registered as active in NPPES database

📍
Updated Practice Location July 11, 2011

Registered at 1748 S TRIVIZ DR, LAS CRUCES, NM 880015103 (Tel: 5755221983)

📍
Updated Business Mailing Address July 11, 2011

Registered at 1748 S TRIVIZ DR, LAS CRUCES, NM 880015103 (Tel: 5755221983)

👤
Provider Name / Credentials Updated July 11, 2011

Recorded as JARED WALLIS, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 11, 2011

Dentist (License #3512 in NM)

🟢
Initial NPI Registration & Enumeration July 11, 2011

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: 1396033494
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 11, 2011
Last Update: February 11, 2019
Sole Proprietor: No

Mailing Address

2540 N Telshor Blvd Ste E

Las Cruces, NM 880118201

Phone: 5755219375

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.