Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1740210103 Individual Practitioner Male Practitioner

Dr. Jody Paul Wallace , DDS

Dentist - General Practice • Graham, NC

Professional Overview & Biography Verified Profile Summary

Dr. Jody Wallace, DDS is a registered healthcare professional specializing in Dentist - General Practice in Graham, NC. Practice services are available at 2148 HIGHWAY 54 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2148 Highway 54

Graham, NC 27253

Telephone 3365783884
Fax 3365783814
Associated Practice Facility / Clinic
🏢 Jerry Crayle Facility NPI 1508237934

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Graham, NC

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 11.6 Yrs
Regional Practice Density
8 Specialists

Practicing in Graham, NC (4047 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 NC 7500

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
89902J1 (NC)

Practice Associates & Co-Workers

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

1 Associated Practitioners
Dr. Jerome Crayle , DDS

Dentist - General Practice

NPI 1790876464

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 July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 2148 HIGHWAY 54, GRAHAM, NC 27253 (Tel: 3365783884)

📍
Updated Business Mailing Address July 08, 2007

Registered at 2148 HIGHWAY 54, GRAHAM, NC 27253 (Tel: 3365783884)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as JODY WALLACE, D.D.S.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #7500 in NC)

🟢
Initial NPI Registration & Enumeration July 03, 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: 1740210103
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 03, 2006
Last Update: July 08, 2007
Sole Proprietor: No

Mailing Address

2148 Highway 54

Graham, NC 27253

Phone: 3365783884

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.