Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1174671721 Deactivated / Inactive NPI Male Practitioner

Dr. John Richard Wallace , DDS

Dentist - General Practice • Plano, TX

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. John Wallace has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date January 08, 2007
NPI Deactivation Date March 14, 2019
Total Practice Duration ~12 Years of Practice (2007 – 2019)

Professional Overview & Biography Verified Profile Summary

Dr. John Wallace, DDS was a registered Dentist - General Practice practicing in Plano, TX. Throughout an active medical career spanning 12 years, Dr. Wallace provided care at the practice location at 4909 WEST PARK BLVD until profile deactivation on 2019-03-14.

Practice Location & Contact Primary Location

Practice Address

4909 West Park Blvd
#117

Plano, TX 750932311

Telephone 9725191990
Fax 9729640047

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Plano, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 12.3 Yrs
Regional Practice Density
222 Specialists

Practicing in Plano, TX (10570 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 TX 8235

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 1205070372

Doctor of Dental Surgery

Career & Practice History Timeline

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

7 Historical Events
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NPI Profile Deactivated March 14, 2019

Record deactivated on March 14, 2019

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 4909 WEST PARK BLVD, #117, PLANO, TX 750932311 (Tel: 9725191990)

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Updated Business Mailing Address July 08, 2007

Registered at 4909 WEST PARK BLVD, #117, PLANO, TX 750932311 (Tel: 9725191990)

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Provider Name / Credentials Updated July 08, 2007

Recorded as JOHN WALLACE, DDS

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

Dentist (License #8235 in TX)

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Initial NPI Registration & Enumeration January 08, 2007

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: 1174671721
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 08, 2007
Last Update: July 08, 2007
Deactivation Date: March 14, 2019

Mailing Address

4909 West Park Blvd, #117

Plano, TX 750932311

Phone: 9725191990

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.