Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kevin D Wallace DMD, PC

Organization Prosthodontics · NPI 1841404019

Kevin D Wallace DMD, PC is a Prosthodontics in Springfield, Missouri. Licensed in Missouri. Registered with an NPI since 2007.

Licensed in
MO
In the registry since
2007
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1200 E Woodhurst Dr Ste 200-A
Springfield, MO 65804-4257
Phone: (417) 881-1123
Fax: (417) 883-0812
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Prosthodontics (primary) Taxonomy 1223P0700X · Licence 014935 (MO)

Record details

NPI number1841404019
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kevin Wallace — Dentist · (417) 881-1123
NPI enumeratedMay 9, 2007
Last updated in NPPESAugust 21, 2008
Mailing address1200 E Woodhurst Dr, Suite 200-A, Springfield, MO 65804-4257

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