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Deactivated NPI 1518043041 Deactivated / Inactive NPI Male Practitioner

Dr. Jesse Reis Wall , DDS

Dentist - General Practice • Danville, VA

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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. Jesse Wall has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 27, 2006
NPI Deactivation Date January 28, 2022
Total Practice Duration ~16 Years of Practice (2006 – 2022)

Professional Overview & Biography Verified Profile Summary

Dr. Jesse Wall, DDS was a registered Dentist - General Practice practicing in Danville, VA. Throughout an active medical career spanning 16 years, Dr. Wall provided care at the practice location at 1045 MAIN ST until profile deactivation on 2022-01-28.

Practice Location & Contact Primary Location

Practice Address

1045 Main St
Suite 6

Danville, VA 245411800

Telephone 4347928622
Fax 4347921512
Associated Practice Facility / Clinic
🏢 Mikhail O. Chizhikov, Md, Llc Facility NPI 1346217809

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Danville, VA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 14.6 Yrs
Regional Practice Density
31 Specialists

Practicing in Danville, VA (3535 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 VA 0401005098

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

12 Associated Practitioners
Gene Smith , LCAS

Counselor - Addiction (Substance Use Disorder)

NPI 1104162056

Licensed Clinical Addiction Specialist

Shelby Vaughan

Counselor - Professional

NPI 1144800186
Stefanie Sheldon , LPC

Counselor - Mental Health

NPI 1265827828

Licensed Professional Counselor

Mindi Perry

Social Worker - Clinical

NPI 1306176599
Jessica Hodges

Behavior Technician

NPI 1326516725
Dr. Ajit Chauhan , MD

Internal Medicine - Cardiovascular Disease

NPI 1457452260

Doctor of Medicine (M.D.)

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 January 28, 2022

Record deactivated on January 28, 2022

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 1045 MAIN ST, SUITE 6, DANVILLE, VA 245411800 (Tel: 4347928622)

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Updated Business Mailing Address July 08, 2007

Registered at 1045 MAIN ST, SUITE 6, DANVILLE, VA 245411800 (Tel: 4347928622)

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Provider Name / Credentials Updated July 08, 2007

Recorded as JESSE WALL, DDS

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

Dentist (License #0401005098 in VA)

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Initial NPI Registration & Enumeration October 27, 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: 1518043041
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 27, 2006
Last Update: July 08, 2007
Deactivation Date: January 28, 2022

Mailing Address

1045 Main St, Suite 6

Danville, VA 245411800

Phone: 4347928622

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.